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General NPI Number Information
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NPI Number | 1386458255
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Entity Type | Organization
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Legal Business Name | PROSTHETICS IN MOTION MELVILLE, LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 1860 WALT WHITMAN RD
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City | MELVILLE
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State | NY
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Zip | 11747-3282
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Country | US
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Telephone | 631-602-9430
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Fax |
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Provider Business Mailing Address
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Address Line | 1860 WALT WHITMAN RD STE 750
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City | MELVILLE
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State | NY
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Zip | 11747-3098
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Country | US
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Telephone | 631-602-9430
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Fax | 631-602-0070
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER JASON KORT
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Credential | CPO
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Telephone | 631-602-9430
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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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