MEDICARE: MAZ 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1326673740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAZ SUPPLY INC.

Provider Business Mailing Address
First Line	:	6701 BAY PKWY STE 304
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4749
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 BAY PKWY STE 304
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-4749
Country	:	US
Telephone Number	:	718-872-9181
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAFAEL BINYAMINOV
Credential	:
Telephone Number	:	718-872-9181

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	03/05/2020

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