Provider Demographics
NPI:1982717310
Name:MGZ HEALTH SOURCE INC.
Entity Type:Organization
Organization Name:MGZ HEALTH SOURCE INC.
Other - Org Name:MGZ HEALTH SUPPLIES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MENACHEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-425-0167
Mailing Address - Street 1:419 ROUTE 59
Mailing Address - Street 2:SUITE 11
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2837
Mailing Address - Country:US
Mailing Address - Phone:845-425-0167
Mailing Address - Fax:845-425-8048
Practice Address - Street 1:419 ROUTE 59
Practice Address - Street 2:SUITE 11
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-2837
Practice Address - Country:US
Practice Address - Phone:845-425-0167
Practice Address - Fax:845-425-8048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02354709Medicaid
NY1000062558OtherAFFINITY
NY7917785OtherAETNA
NY070131000027OtherFIDELIS
NY02354709Medicaid