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General NPI Number Information
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NPI Number | 1467668186
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Entity Type | Organization
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Legal Business Name | SCOLIOSIS SYSTEMS ORTHOTICS AND PROSTHETICS, LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1085 PARK AVE SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10128-1168
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Country | US
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Telephone | 212-360-7760
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Fax | 212-360-7974
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Provider Business Mailing Address
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Address Line | 1085 PARK AVE SUITE 1E
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City | NEW YORK
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State | NY
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Zip | 10128-1168
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Country | US
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Telephone | 212-360-7760
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Fax | 212-360-7974
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MARC J. LAMANTIA
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Credential | D.C
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Telephone | 212-360-7760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | X8247
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License Number State | NY
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