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General NPI Number Information
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NPI Number | 1891964029
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Entity Type | Organization
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Legal Business Name | LORELEI ORTHOTICS & PROSTHETICS, INC.
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 200 VETERANS RD BUILDING A, GROUND FLOOR
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4130
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Country | US
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Telephone | 914-962-3814
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Fax | 212-727-0844
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Provider Business Mailing Address
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Address Line | 19 W 21ST ST SUITE 204
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City | NEW YORK
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State | NY
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Zip | 10010-6805
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Country | US
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Telephone | 212-727-2011
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Fax | 212-727-0844
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRIAN P KILCOMMONS
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Credential | C.O.
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Telephone | 212-727-2011
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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 |
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License Number State |
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