Eastside Orthotics And Prosthetics, INC.
Prosthetic/Orthotic Supplier in New York, NY. Organization (NPI-2).
NPI number1982608493
StatusActive
Last updated in NPPESSep 19, 2007
Details
- NPI
- 1982608493
- Entity type
- Organization (NPI-2)
- Legal business name
- Eastside Orthotics And Prosthetics, INC.
- Organization subpart
- No
- Enumeration date
- Jun 13, 2005
- Last updated
- Sep 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Practice location
622 W 168th StVc333
New York, NY 10032
Phone 212-305-3275 · Fax 212-305-5927
Mailing address
34 Commerce DrSuite 200
Riverhead, NY 11901-3174
Phone 631-727-8735 · Fax 631-727-6834
Authorized official
Matthew D Flynn
President
6317278735
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