Healthcare Provider Details

I. General information

NPI: 1831437664
Provider Name (Legal Business Name): RULLO TRADING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2013
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7143 69TH ST
GLENDALE NY
11385-7236
US

IV. Provider business mailing address

7812 84TH ST
GLENDALE NY
11385-7611
US

V. Phone/Fax

Practice location:
  • Phone: 347-298-9087
  • Fax: 347-599-0618
Mailing address:
  • Phone: 917-842-3294
  • Fax: 347-599-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: ANTONIO RULLO
Title or Position: OWNER/CEO
Credential:
Phone: 917-842-3294