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General NPI Number Information
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NPI Number | 1104952670
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Entity Type | Organization
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Legal Business Name | NEW SCHOOL PROSTHETICS & ORTHOTICS
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9041 160TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-6125
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Country | US
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Telephone | 718-739-6345
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Fax | 718-739-6345
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Provider Business Mailing Address
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Address Line | 9041 160TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-6125
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Country | US
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Telephone | 718-739-6345
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Fax | 718-739-6345
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Authorized Official
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Title or Position | PARTNER
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Name | MR. HANSEM SO
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Credential | BOCPO
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Telephone | 917-699-9384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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