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General NPI Number Information
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NPI Number | 1619043932
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Entity Type | Organization
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Legal Business Name | JK PROSTHETICS AND ORTHOTICS
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 699 N MACQUESTEN PKWY
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City | MOUNT VERNON
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State | NY
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Zip | 10552-2121
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Country | US
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Telephone | 914-699-2077
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Fax | 914-699-0676
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Provider Business Mailing Address
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Address Line | 699 N MACQUESTEN PKWY
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City | MOUNT VERNON
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State | NY
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Zip | 10552-2121
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Country | US
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Telephone | 914-699-2077
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Fax | 914-699-0676
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Authorized Official
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Title or Position | MANAGER
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Name | MR. MICHAEL JAMES CAPUTO
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Credential |
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Telephone | 914-699-2077
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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 |
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License Number State |
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