MEDICARE: ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, 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
2	G5655-1	OTHER	NM	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1659458040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, INC.

Provider Business Mailing Address
First Line	:	510 E 73RD ST
Second Line	:	SUITE 201A
City	:	NEW YORK
State	:	NY
Zip	:	10021-4010
Country	:	US
Telephone Number	:	212-606-1262
Fax Number	:	212-606-1842

Provider Business Practice Location Address
First Line	:	510 E 73RD ST
Second Line	:	SUITE 201A
City	:	NEW YORK
State	:	NY
Zip	:	10021-4010
Country	:	US
Telephone Number	:	212-606-1262
Fax Number	:	212-606-1842

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ANDREW H MEYERS
Credential	:	CPO
Telephone Number	:	212-606-1262

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	11/18/2011

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