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General NPI Number Information
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NPI Number | 1508840141
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Entity Type | Organization
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Legal Business Name | CHOICE LIMB & BRACE
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 555A S COLUMBUS AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-4731
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Country | US
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Telephone | 914-479-0743
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Fax | 914-479-1568
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Provider Business Mailing Address
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Address Line | 555A S COLUMBUS AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-4731
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Country | US
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Telephone | 914-479-0743
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Fax | 914-479-1568
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Authorized Official
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Title or Position | CPO CRED
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Name | MR. ANTHONY J SQUICCIARINI
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Credential |
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Telephone | 914-479-0743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 1230265
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License Number State | NY
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Taxonomy #2
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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 | NY
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