Healthcare Provider Details

I. General information

NPI: 1922119007
Provider Name (Legal Business Name): ADVANCED PROSTHETICS AND ORTHOTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MAPLE PL
MANHASSET NY
11030-1927
US

IV. Provider business mailing address

50 MAPLE PL
MANHASSET NY
11030-1927
US

V. Phone/Fax

Practice location:
  • Phone: 516-365-7225
  • Fax: 516-365-7112
Mailing address:
  • Phone: 516-365-7225
  • Fax: 516-365-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01091212
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: MR. MICHAEL A. JOYCE
Title or Position: PRESIDENT
Credential: CP
Phone: 516-365-7225