MEDICARE: MRS. AGNIESZKA MERGO-BIELECKA II

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	183500000X	Pharmacist	055647	NY
2	183500000X	Pharmacist	28RI02936400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750551701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AGNIESZKA MERGO-BIELECKA II

Provider Business Mailing Address
First Line	:	9511 63RD DR
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2024
Country	:	US
Telephone Number	:	718-897-0803
Fax Number	:	718-897-0804

Provider Business Practice Location Address
First Line	:	9511 63RD DR
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-2024
Country	:	US
Telephone Number	:	718-897-0803
Fax Number	:	718-897-0804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	04/23/2020

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