MEDICARE: A&G MEDICAL SUPPLY

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	1416768	NY

General Provider Information

NPI Number	:	1508138371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&G MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	1040 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461
Country	:	US
Telephone Number	:	718-823-4700
Fax Number	:	718-823-4800

Provider Business Practice Location Address
First Line	:	1040 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1411
Country	:	US
Telephone Number	:	718-823-4700
Fax Number	:	718-823-4800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GIORGIO MASELLI
Credential	:
Telephone Number	:	718-823-4700

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/08/2012

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