Healthcare Provider Details

I. General information

NPI: 1053763268
Provider Name (Legal Business Name): ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W 168TH ST APT 24
NEW YORK NY
10032-3707
US

IV. Provider business mailing address

510 E 73RD ST SUITE 201A
NEW YORK NY
10021-4010
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-3275
  • Fax: 212-305-5927
Mailing address:
  • Phone: 212-606-1262
  • Fax: 212-606-1842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANDREW H MEYERS
Title or Position: PRESIDENT
Credential: CPO
Phone: 212-606-1262