MEDICARE: DELTA ORTHOPEDIC LAB., INC.

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	225000000X	Orthotic Fitter	45PO00000400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235277336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA ORTHOPEDIC LAB., INC.

Provider Business Mailing Address
First Line	:	1010 SUMMIT AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3519
Country	:	US
Telephone Number	:	201-222-7777
Fax Number	:	201-222-7740

Provider Business Practice Location Address
First Line	:	1010 SUMMIT AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3519
Country	:	US
Telephone Number	:	201-222-7777
Fax Number	:	201-222-7740

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GBOLAHAN L SASONA
Credential	:	CPO, LPO
Telephone Number	:	201-222-7777

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	10/03/2012

Similar Medicare Providers

1033211818 — HARRY ERNEST BROWN D.C.
Practice Location Address:

5538 OLIVE ST
KANSAS CITY, MO
64130-3519

Practice Phone: 816-363-7769
Practice Fax: 816-363-7769

1003955394 — GEORGE C RONTIRIS RPH
Practice Location Address:

3519 31ST AVE
LONG ISLAND CITY, NY
11106-1408

Practice Phone: 718-267-8063
Practice Fax:

1548471303 — DEVELOPMENT SPECIALTY PROJECTS, INC.
Practice Location Address:

4800 FRESHMAN DR
CULVER CITY, CA
90230-3519

Practice Phone: 909-821-8023
Practice Fax: 818-804-4047

1881872117 — ALBERT L. PISANI MD A MEDICAL CORP
Practice Location Address:

3519 ALTAMONT WAY
REDWOOD CITY, CA
94062-3105

Practice Phone: 650-722-8636
Practice Fax:

1699914267 — GEORGE NICHOLAS BALDWIN M.D.
Practice Location Address:

3519 E. ARCATA R
SALT LAKE CITY, UT
84124-4738

Practice Phone: 801-277-5337
Practice Fax:

1003114646 — MS. ELENI TRIFOS RPH
Practice Location Address:

3519 31ST AVE
LONG ISLAND CITY, NY
11106-1408

Practice Phone: 718-267-8063
Practice Fax:

Directions to “DELTA ORTHOPEDIC LAB., INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.