Healthcare Provider Details

I. General information

NPI: 1790879443
Provider Name (Legal Business Name): EURO O & P, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4454 RT. 27
KINGSTON NJ
08528
US

IV. Provider business mailing address

4454 RT. 27
KINGSTON NJ
08528
US

V. Phone/Fax

Practice location:
  • Phone: 609-430-9020
  • Fax: 609-430-9070
Mailing address:
  • Phone: 609-430-9020
  • Fax: 609-430-9070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number45PO00010300
License Number StateNJ

VIII. Authorized Official

Name: MR. BODI MIHOV
Title or Position: PRESIDENT
Credential: LO, LP
Phone: 609-430-9020