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General NPI Number Information
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NPI Number | 1255582128
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Entity Type | Organization
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Legal Business Name | PRECISION SHOE BRACE & LIMBS LLC
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1025 W SAINT GEORGES AVE STE 3
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City | LINDEN
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State | NJ
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Zip | 07036-6134
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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 | 1025 WEST ST. GEORGES AVENUE - SUITE 3 PO BOX 1213
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City | LINDEN
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State | NJ
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Zip | 07036-6134
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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 | PRESIDENT
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Name | MR. PAUL D GOODMAN
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Credential | C.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 | 45PO00007500
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License Number State | NJ
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