Healthcare Provider Details

I. General information

NPI: 1457681652
Provider Name (Legal Business Name): COMPLETE ORTHOPEDIC SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5713 MAIN ST
FLUSHING NY
11355-5332
US

IV. Provider business mailing address

2094 FRONT ST
EAST MEADOW NY
11554-1709
US

V. Phone/Fax

Practice location:
  • Phone: 718-321-0407
  • Fax: 718-321-3484
Mailing address:
  • Phone: 516-357-9113
  • Fax: 516-478-4420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. NOREEN DIAZ
Title or Position: PRESIDENT
Credential:
Phone: 516-357-9113