MEDICARE: BELMONT MEDICAL & SURGICAL SUPPLY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	1397887	NY

General Provider Information

NPI Number	:	1093001034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELMONT MEDICAL & SURGICAL SUPPLY, INC.

Provider Business Mailing Address
First Line	:	14 BELMONT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6443
Country	:	US
Telephone Number	:	347-435-3355
Fax Number	:	347-435-3354

Provider Business Practice Location Address
First Line	:	14 BELMONT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6443
Country	:	US
Telephone Number	:	347-435-3355
Fax Number	:	347-435-3354

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OKSANA AULOVA
Credential	:
Telephone Number	:	646-331-8798

Provider Enumeration Date	:	06/28/2011
Last Update Date	:	10/11/2016

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