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General NPI Number Information
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NPI Number | 1720063555
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Entity Type | Organization
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Legal Business Name | NATIONAL PROSTHETIC ORTHOTIC ASSOCIATES, INC
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21441 42ND AVE 3RD FLOOR
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City | BAYSIDE
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State | NY
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Zip | 11361-2963
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Country | US
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Telephone | 718-423-8700
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Fax | 718-423-8708
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Provider Business Mailing Address
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Address Line | 21441 42ND AVE 3RD FLOOR
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City | BAYSIDE
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State | NY
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Zip | 11361-2963
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Country | US
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Telephone | 718-423-8700
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Fax | 718-423-8708
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERNANDO ONEL PEREZ
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Credential | PROSTHETIST
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Telephone | 718-423-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | P-1113
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License Number State | NY
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