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General NPI Number Information
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NPI Number | 1871732826
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Entity Type | Organization
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Legal Business Name | NEW YORK ORTHOTIC & PROSTHETIC ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 810 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4514
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Country | US
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Telephone | 516-216-1888
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Fax | 516-233-1889
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Provider Business Mailing Address
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Address Line | 810 JERICHO TPKE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-4514
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Country | US
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Telephone | 516-216-1888
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Fax | 516-233-1889
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Authorized Official
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Title or Position | MEMBER
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Name | JEFFREY BONNEVILLE
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Credential | CPO
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Telephone | 516-216-1888
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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 | N/A
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License Number State |
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