Healthcare Provider Details

I. General information

NPI: 1326079781
Provider Name (Legal Business Name): DE LA TORRE ORTHOTICS & PROSTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ALPHA DR
PITTSBURGH PA
15238-2908
US

IV. Provider business mailing address

300 ALPHA DR
PITTSBURGH PA
15238-2908
US

V. Phone/Fax

Practice location:
  • Phone: 412-599-1138
  • Fax: 412-599-1130
Mailing address:
  • Phone: 412-599-1138
  • Fax: 412-599-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNA
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberNA
License Number State
# 3
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberNA
License Number State

VIII. Authorized Official

Name: ANN LEIMKUEHLER MOSS
Title or Position: PRESIDENT
Credential:
Phone: 412-325-2650