Healthcare Provider Details
I. General information
NPI: 1700353059
Provider Name (Legal Business Name): ADAPTIVE PROSTHETICS & ORTHOTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/25/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 MEADOW STREET EXT STE 102
AGAWAM MA
01001-2019
US
IV. Provider business mailing address
90 NATIONAL DR STE 1
GLASTONBURY CT
06033-1247
US
V. Phone/Fax
- Phone: 413-443-4431
- Fax: 413-278-2239
- Phone: 860-633-7298
- Fax: 860-659-1282
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
IVAN
SABEL
Title or Position: CEO
Credential:
Phone: 860-633-7298