Healthcare Provider Details

I. General information

NPI: 1134423312
Provider Name (Legal Business Name): ADVANCED ORTHOPEDIC EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8931 161ST ST MAIN FLOOR
JAMAICA NY
11432-6102
US

IV. Provider business mailing address

78 MARINA RD
ISLAND PARK NY
11558-1007
US

V. Phone/Fax

Practice location:
  • Phone: 718-291-6161
  • Fax: 718-526-6169
Mailing address:
  • Phone: 516-984-6692
  • Fax: 516-706-1504

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 NumberN004623
License Number StateNY

VIII. Authorized Official

Name: STEVEN PRINCE
Title or Position: OWNER/PRESIDENT
Credential: D.P.M.
Phone: 516-782-1332