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General NPI Number Information
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NPI Number | 1588503569
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Entity Type | Organization
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Legal Business Name | VITALONYX MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 733 YONKERS AVE STE 106
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City | YONKERS
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State | NY
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Zip | 10704-2659
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Country | US
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Telephone | 201-641-2125
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Fax | 212-888-6024
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Provider Business Mailing Address
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Address Line | 733 YONKERS AVE STE 106
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City | YONKERS
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State | NY
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Zip | 10704-2659
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Country | US
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Telephone | 201-641-2125
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Fax | 212-888-6024
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Authorized Official
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Title or Position | OWNER
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Name | ALTAGRACIA DE JESUS
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Credential |
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Telephone | 347-213-6894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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