MEDICARE: ISLAND ORTHOTIC & PROSTHETIC ASSOCIATES, 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	:	1760487466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISLAND ORTHOTIC & PROSTHETIC ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	294 W MERRICK RD
Second Line	:	STE 10
City	:	FREEPORT
State	:	NY
Zip	:	11520-3357
Country	:	US
Telephone Number	:	516-377-9033
Fax Number	:	516-623-9585

Provider Business Practice Location Address
First Line	:	294 W MERRICK RD
Second Line	:	STE 10
City	:	FREEPORT
State	:	NY
Zip	:	11520-3357
Country	:	US
Telephone Number	:	516-377-9033
Fax Number	:	516-623-9585

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH J RIZZUTO II
Credential	:	CPO
Telephone Number	:	516-377-9033

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/22/2020

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