Healthcare Provider Details

I. General information

NPI: 1356551980
Provider Name (Legal Business Name): DM ORTHOTIC & PROSTHETIC, INCC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24-12 150 TH STREET
WHITESTONE NY
11357
US

IV. Provider business mailing address

12 UNITY COURT
NESCONSET NE
11767
US

V. Phone/Fax

Practice location:
  • Phone: 718-762-4582
  • Fax: 718-762-4592
Mailing address:
  • Phone: 516-242-1649
  • Fax: 631-224-2672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DAVID P MARKOWITZ
Title or Position: OWNER
Credential:
Phone: 516-242-1649