MEDICARE: NOUVEAU P & O LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1053376871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOUVEAU P & O LTD

Provider Business Mailing Address
First Line	:	5422 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4037
Country	:	US
Telephone Number	:	718-871-2222
Fax Number	:	718-871-1478

Provider Business Practice Location Address
First Line	:	5422 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4037
Country	:	US
Telephone Number	:	718-871-2222
Fax Number	:	718-871-1478

Authorized Official
Title or Position	:	OWNER DIRECTOR
Name	:	MR. STUART WEINER
Credential	:
Telephone Number	:	718-871-2222

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	04/29/2008

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