Healthcare Provider Details

I. General information

NPI: 1285856385
Provider Name (Legal Business Name): SUPPORT BY DESIGN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 THOMAS ST FLOOR #1
NEW YORK NY
10013
US

IV. Provider business mailing address

60 THOMAS ST FLOOR #1
NEW YORK NY
10013
US

V. Phone/Fax

Practice location:
  • Phone: 917-902-1029
  • Fax: 212-608-9660
Mailing address:
  • Phone: 917-902-1029
  • Fax: 212-608-9660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA L. ROWE
Title or Position: ORTHOTIST
Credential: C.O.
Phone: 917-902-1029