Healthcare Provider Details

I. General information

NPI: 1093984338
Provider Name (Legal Business Name): ORTHOPRO SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E 55TH ST SUITE 207
NEW YORK NY
10022-4038
US

IV. Provider business mailing address

155 E 55TH ST SUITE 207
NEW YORK NY
10022-4038
US

V. Phone/Fax

Practice location:
  • Phone: 212-888-7372
  • Fax: 212-888-1551
Mailing address:
  • Phone: 212-888-7372
  • Fax: 212-888-1551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JACK AIZENSTEIN
Title or Position: PRESIDENT
Credential: CO
Phone: 212-888-7372