Healthcare Provider Details
I. General information
NPI: 1073315461
Provider Name (Legal Business Name): PROSTHETIC & ORTHOTIC ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
510 ROUTE 6 AND 209 STE 102
MILFORD PA
18337-7615
US
IV. Provider business mailing address
4 RIVERSIDE DR
MIDDLETOWN NY
10941-4064
US
V. Phone/Fax
- Phone: 845-956-0001
- Fax:
- Phone: 845-956-0001
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
PASSERO
Title or Position: PRESIDENT/DIRECTOR OF OPERATIONS
Credential:
Phone: 845-956-0001