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NPI Code Detail

MEDICARE: E&G PROSTHETICS AND ORTHOTICS, LLC

MEDICARE: E&G PROSTHETICS AND ORTHOTICS, LLC
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
1335E00000XProsthetic/Orthotic Supplier

General Provider Information

NPI Number : 1952141251
Entity Type Code : Organization
Provider Name (Legal Business Name) : E&G PROSTHETICS AND ORTHOTICS, LLC
Provider Business Mailing Address
First Line : 2305 ASTORIA BLVD
Second Line :
City : ASTORIA
State : NY
Zip : 11102-4345
Country : US
Telephone Number : 917-832-6454
Fax Number : 917-832-6640
Provider Business Practice Location Address
First Line : 1546 MADISON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10029-4551
Country : US
Telephone Number : 917-717-4607
Fax Number : 917-717-8894
Authorized Official
Title or Position : MEMBER
Name : VASILIOS KEHAGIAS
Credential : C.P.O.
Telephone Number : 917-832-6454
Provider Enumeration Date : 05/27/2024
Last Update Date : 05/27/2024

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Directions to “E&G PROSTHETICS AND ORTHOTICS, LLC ” Practice Location

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