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General NPI Number Information
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NPI Number | 1134161557
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Entity Type | Organization
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Legal Business Name | PRECISION ORTHOTICS AND PROSTHETICS INC.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 618 W ELIZABETH AVE
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City | LINDEN
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State | NJ
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Zip | 07036-4240
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Country | US
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Telephone | 908-486-8636
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Fax | 908-523-0036
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Provider Business Mailing Address
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Address Line | 618 W ELIZABETH AVE P.O. BOX 1213
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City | LINDEN
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State | NJ
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Zip | 07036-4240
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Country | US
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Telephone | 908-486-8636
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Fax | 908-523-0036
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Authorized Official
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Title or Position | OWNER
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Name | MR. PAUL D GOODMAN
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Credential | C.O. ,L.P.O
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Telephone | 908-486-8636
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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 |
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License Number State |
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