MEDICARE: INTERPRO SYSTEMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier	45OR00000100	NJ

General Provider Information

NPI Number	:	1093975518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERPRO SYSTEMS

Provider Business Mailing Address
First Line	:	29 OVERLOOK RD
Second Line	:
City	:	CHATHAM TWP
State	:	NJ
Zip	:	07928-1512
Country	:	US
Telephone Number	:	908-790-9222
Fax Number	:	973-301-0899

Provider Business Practice Location Address
First Line	:	3049 OCEAN PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8372
Country	:	US
Telephone Number	:	908-790-9222
Fax Number	:	973-301-0899

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DAVID M RABE
Credential	:	CPO LP LO
Telephone Number	:	908-790-9222

Provider Enumeration Date	:	06/10/2008
Last Update Date	:	06/10/2008

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