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General NPI Number Information
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NPI Number | 1982774923
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Entity Type | Organization
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Legal Business Name | BAY STATE BRACE CO INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 599 NORTH AVE DOOR 9 2ND FLOOR
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City | WAKEFIELD
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State | MA
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Zip | 01880-1622
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Country | US
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Telephone | 781-224-3505
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Fax | 781-224-3507
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Provider Business Mailing Address
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Address Line | 599 NORTH AVE DOOR 9 2ND FLOOR
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City | WAKEFIELD
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State | MA
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Zip | 01880-1648
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Country | US
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Telephone | 781-224-3505
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Fax | 781-224-3507
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | MR. JAMES CARL KRUPA
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Credential | CO
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Telephone | 781-224-3505
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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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Taxonomy #2
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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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