Healthcare Provider Details

I. General information

NPI: 1477631646
Provider Name (Legal Business Name): TONAWANDA LIMB & BRACE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 DELAWARE STREET
TONAWANDA NY
14150
US

IV. Provider business mailing address

545 DELAWARE STREET
TONAWANDA NY
14150
US

V. Phone/Fax

Practice location:
  • Phone: 716-695-1131
  • Fax: 716-695-0016
Mailing address:
  • Phone: 716-695-1131
  • Fax: 716-695-0016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD CATIPOVIC
Title or Position: COMPANY PRESIDENT
Credential: CERTIFIED PROSTHESIS
Phone: 716-695-1131