Provider Demographics
NPI:1215122973
Name:NY ADVANCED MEDICAL PRODUCTS, LLC
Entity type:Organization
Organization Name:NY ADVANCED MEDICAL PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAZONAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-220-5782
Mailing Address - Street 1:3244 31ST ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2630
Mailing Address - Country:US
Mailing Address - Phone:718-956-1771
Mailing Address - Fax:
Practice Address - Street 1:3244 31ST ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-2630
Practice Address - Country:US
Practice Address - Phone:718-204-1125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6063530001Medicare NSC