Healthcare Provider Details
I. General information
NPI: 1699441857
Provider Name (Legal Business Name): AFI ORTHOTICS & PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2021
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
65 NORTH FRONTAGE RD
EAST HAVEN CT
06512-2100
US
IV. Provider business mailing address
65 NORTH FRONTAGE RD
EAST HAVEN CT
06512-2100
US
V. Phone/Fax
- Phone: 203-535-1986
- Fax: 203-621-3134
- Phone: 860-833-8459
- Fax: 203-621-3134
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
BARTON
MAHLER
Title or Position: OWNER
Credential: CPO
Phone: 860-833-8459