Provider Demographics
NPI:1467247924
Name:AMG PHARMA, INC.
Entity type:Organization
Organization Name:AMG PHARMA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GIA
Authorized Official - Last Name:ISRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-855-0081
Mailing Address - Street 1:31 MIDDLE NECK RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2304
Mailing Address - Country:US
Mailing Address - Phone:516-855-0081
Mailing Address - Fax:516-855-0082
Practice Address - Street 1:31 MIDDLE NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2304
Practice Address - Country:US
Practice Address - Phone:516-855-0081
Practice Address - Fax:516-855-0082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy