1184179152 NPI number — ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184179152 NPI number — ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESCHEN PROSTHETIC & ORTHOTIC LABORATORIES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184179152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

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

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
889 HARRISON AVE
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
RIVERHEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11901-2090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-727-8735
Provider Business Practice Location Address Fax Number:
631-727-6834
Provider Enumeration Date:
08/19/2016

Additional Information

Authorized Official

Authorized Official Last Name:
MEYERS
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-606-1262

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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