Provider Demographics
NPI:1992435705
Name:MAGER & GOUGELMAN, INC.
Entity type:Organization
Organization Name:MAGER & GOUGELMAN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-661-3939
Mailing Address - Street 1:144 E 44TH ST STE 602
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4008
Mailing Address - Country:US
Mailing Address - Phone:212-661-3968
Mailing Address - Fax:877-592-0206
Practice Address - Street 1:297 KNOLLWOOD RD STE 304
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1849
Practice Address - Country:US
Practice Address - Phone:914-292-5148
Practice Address - Fax:973-475-4547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies