MEDICARE: CLINICAL PROMOTIONAL MARKETING

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	332BC3200X	Customized Equipment (DME)		NY

General Provider Information

NPI Number	:	1487663829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL PROMOTIONAL MARKETING

Provider Business Mailing Address
First Line	:	14 GLEN COVE RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1732
Country	:	US
Telephone Number	:	516-621-7653
Fax Number	:	516-801-2112

Provider Business Practice Location Address
First Line	:	14 GLEN COVE RD
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1732
Country	:	US
Telephone Number	:	516-621-7653
Fax Number	:	516-801-2112

Authorized Official
Title or Position	:	PRES. CERTIFIED ORTHOTIST
Name	:	MR. STEVEN M GOLDSTEIN
Credential	:	CO
Telephone Number	:	516-621-0379

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/21/2022

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Directions to “CLINICAL PROMOTIONAL MARKETING ” Practice Location

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