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General NPI Number Information
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NPI Number | 1023368800
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Entity Type | Organization
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Legal Business Name | SUNSHINE PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 1700 ROUTE 23 SUITE 180
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City | WAYNE
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State | NJ
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Zip | 07470-7536
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Country | US
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Telephone | 973-696-8100
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Fax | 973-696-8101
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Provider Business Mailing Address
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Address Line | 1700 ROUTE 23 SUITE 180
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City | WAYNE
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State | NJ
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Zip | 07470-7536
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Country | US
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Telephone | 973-696-8100
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Fax | 973-696-8101
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MS. BROOKE ARTESI
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Credential | CPO,LPO
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Telephone | 973-610-6678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 45OR00003100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 45PR00003500
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License Number State | NJ
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