MEDICARE: NY ADVANCED MEDICAL PRODUCTS, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1215122973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NY ADVANCED MEDICAL PRODUCTS, LLC

Provider Business Mailing Address
First Line	:	3244 31ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2630
Country	:	US
Telephone Number	:	718-956-1771
Fax Number	:

Provider Business Practice Location Address
First Line	:	3244 31ST ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2630
Country	:	US
Telephone Number	:	718-204-1125
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OLGA GAZONAS
Credential	:	DC
Telephone Number	:	516-220-5782

Provider Enumeration Date	:	09/06/2007
Last Update Date	:	07/23/2008

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