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General NPI Number Information
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NPI Number | 1598559932
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Entity Type | Organization
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Legal Business Name | BG BRACING, LLC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 84 HOPPER AVE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1245
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Country | US
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Telephone | 973-494-6336
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Fax | 973-341-7791
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Provider Business Mailing Address
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Address Line | 84 HOPPER AVE
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City | POMPTON PLAINS
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State | NJ
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Zip | 07444-1245
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Country | US
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Telephone | 973-494-6336
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Fax | 973-341-7791
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Authorized Official
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Title or Position | OWNER
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Name | SIYKA D'AGOSTINO
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Credential |
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Telephone | 973-494-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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