Healthcare Provider Details

I. General information

NPI: 1982774923
Provider Name (Legal Business Name): BAY STATE BRACE CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

599 NORTH AVE DOOR 9 2ND FLOOR
WAKEFIELD MA
01880-1622
US

IV. Provider business mailing address

599 NORTH AVE DOOR 9 2ND FLOOR
WAKEFIELD MA
01880-1648
US

V. Phone/Fax

Practice location:
  • Phone: 781-224-3505
  • Fax: 781-224-3507
Mailing address:
  • Phone: 781-224-3505
  • Fax: 781-224-3507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES CARL KRUPA
Title or Position: OWNER-PRESIDENT
Credential: CO
Phone: 781-224-3505