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General NPI Number Information
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NPI Number | 1942935846
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Entity Type | Organization
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Legal Business Name | JR PROSTHETICS AND ORTHOTICS LLC
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Dates
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Enumeration Date | 07/24/2022
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Last Update Date | 07/24/2022
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Provider Practice Location Address
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Address Line | 4223 FRANCIS LEWIS BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-2575
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Country | US
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Telephone | 347-804-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 4223 FRANCIS LEWIS BLVD
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City | BAYSIDE
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State | NY
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Zip | 11361-2575
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JAVEED RANGREZ
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Credential |
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Telephone | 347-804-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 222Z00000X
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Taxonomy Name | Orthotist
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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 | 224L00000X
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Taxonomy Name | Pedorthist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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