=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467889303
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEHNEIS ORTHOPEDIC SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2013
-----------------------------------------------------
Last Update Date | 03/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 93 MAIN ST STE 1B
-----------------------------------------------------
City | WEST SAYVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11796-1832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-750-5766
-----------------------------------------------------
Fax | 631-677-1544
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 62 GRASSMERE AVE
-----------------------------------------------------
City | OAKDALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11769-1911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-807-4435
-----------------------------------------------------
Fax | 631-677-1544
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | ROGER C LEHNEIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 631-750-5766
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------