Healthcare Provider Details

I. General information

NPI: 1336324086
Provider Name (Legal Business Name): KONRAD PROSTHETICS AND ORTHOTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 03/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 FULTON AVE
HEMPSTEAD NY
11550-4135
US

IV. Provider business mailing address

475 FULTON AVE
HEMPSTEAD NY
11550-4135
US

V. Phone/Fax

Practice location:
  • Phone: 516-292-1180
  • Fax:
Mailing address:
  • Phone: 516-292-1180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KURT KONRAD
Title or Position: OWNER, PRESIDENT
Credential:
Phone: 516-485-9164