MEDICARE: NBB 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	335E00000X	Prosthetic/Orthotic Supplier

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	:	1508844507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NBB ORTHOTICS INC

Provider Business Mailing Address
First Line	:	3115 LONG BEACH RD STE 310
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3253
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 LONG BEACH RD STE 310
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3253
Country	:	US
Telephone Number	:	516-594-9066
Fax Number	:	516-594-9067

Authorized Official
Title or Position	:	PRESIDENT OF NBB ORTHOTICS INC
Name	:	MR. NEIL BYRON BERGMAN
Credential	:	CERTIFIED ORTHOTIST
Telephone Number	:	516-594-9066

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	11/07/2025

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