DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: EASTSIDE ORTHOTICS & PROSTHETICS INC

MEDICARE: EASTSIDE ORTHOTICS & PROSTHETICS INC
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
1332B00000XDurable Medical Equipment & Medical Supplies
2335E00000XProsthetic/Orthotic Supplier

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093719593
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTSIDE ORTHOTICS & PROSTHETICS INC
Provider Business Mailing Address
First Line : 34 COMMERCE DR
Second Line : STE 200
City : RIVERHEAD
State : NY
Zip : 11901-3118
Country : US
Telephone Number : 631-727-8735
Fax Number : 631-727-6834
Provider Business Practice Location Address
First Line : 26 PALMERS HILL RD
Second Line : RM 1000
City : STAMFORD
State : CT
Zip : 06902-2113
Country : US
Telephone Number : 203-975-9004
Fax Number : 203-975-9008
Authorized Official
Title or Position : PRESIDENT
Name : MR. MATTHEW D FLYNN
Credential : CP
Telephone Number : 631-727-8735
Provider Enumeration Date : 06/13/2005
Last Update Date : 06/05/2008

Similar Medicare Providers

1013438555 — WILLIAM EARL EZZELLE LPC
Practice Location Address:
60 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-614-9942
Practice Fax:
1447306600 — DR. ISHANI RAY-DATTA M.D.
Practice Location Address:
26 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-656-3130
Practice Fax:
1760680359 — GILDO CONSOLINI LCSW
Practice Location Address:
60 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-324-3167
Practice Fax:
1336390038 — NEREIDA NUNEZ
Practice Location Address:
60 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-629-2822
Practice Fax:
1538310941 — MICHELLE KREPAK
Practice Location Address:
60 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-629-2822
Practice Fax:
1699000729 — RUTHANN JAFFE BIRNBAUM LCSW
Practice Location Address:
60 PALMERS HILL RD
STAMFORD, CT
06902-2113
Practice Phone: 203-629-2822
Practice Fax: 203-629-2940

Directions to “EASTSIDE ORTHOTICS & PROSTHETICS INC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.