MEDICARE: BD O & P 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	335E00000X	Prosthetic/Orthotic Supplier	C36411	NY

General Provider Information

NPI Number	:	1508121393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BD O & P INC.

Provider Business Mailing Address
First Line	:	943 46TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2332
Country	:	US
Telephone Number	:	718-437-3200
Fax Number	:	718-483-8057

Provider Business Practice Location Address
First Line	:	1310 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3521
Country	:	US
Telephone Number	:	718-437-3200
Fax Number	:	718-483-8057

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAMUEL D TEITELBAUM
Credential	:	C PED
Telephone Number	:	718-437-3200

Provider Enumeration Date	:	07/09/2012
Last Update Date	:	07/09/2012

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Directions to “BD O & P INC. ” Practice Location

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