MEDICARE: LIBERTY ORTHOTICS, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1497448567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY ORTHOTICS, INC.

Provider Business Mailing Address
First Line	:	1201 2ND AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-5052
Country	:	US
Telephone Number	:	516-326-6786
Fax Number	:	516-326-6784

Provider Business Practice Location Address
First Line	:	1201 2ND AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-5052
Country	:	US
Telephone Number	:	516-326-6786
Fax Number	:	516-326-6784

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FRANCIS XAVIER BRANDT SR.
Credential	:
Telephone Number	:	516-326-6786

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/02/2023

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Directions to “LIBERTY ORTHOTICS, INC. ” Practice Location

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