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NPI 1093639445

NPI 1093639445 : ROBERT HENRY VON BARGEN CPO : ALBERTSON, NY

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General NPI Number Information
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    NPI Number           |    1093639445
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERT HENRY VON BARGEN CPO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/07/2026
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    Last Update Date     |    08/07/2026
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Provider Practice Location Address
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    Address Line         |    1111 WILLIS AVE 
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    City                 |    ALBERTSON
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    State                |    NY
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    Zip                  |    11507-1230
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    Country              |    US
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    Telephone            |    516-338-8585
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    Fax                  |    516-338-7575
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Provider Business Mailing Address
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    Address Line         |    1111 WILLIS AVE 
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    City                 |    ALBERTSON
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    State                |    NY
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    Zip                  |    11507-1230
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    Country              |    US
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    Telephone            |    516-338-8585
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    Fax                  |    516-338-7575
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    222Z00000X
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    Taxonomy Name        |    Orthotist
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    License Number       |    CPO4200
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    224P00000X
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    Taxonomy Name        |    Prosthetist
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    License Number       |    CPO4200
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    License Number State |    NY
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