1356346928 NPI number — ALL ISLAND ORTHOTICS & PROSTHETICS, 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 1356346928 NPI number — ALL ISLAND ORTHOTICS & PROSTHETICS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL ISLAND ORTHOTICS & PROSTHETICS, 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:
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:
1356346928
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 MAPLE PLACE
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
MANHASSET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-321-9652
Provider Business Mailing Address Fax Number:
516-365-7112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 MAPLE PLACE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
MANHASSET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-321-9652
Provider Business Practice Location Address Fax Number:
516-365-7112
Provider Enumeration Date:
06/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JOYCE
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
516-365-7225

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)

  • Identifier: 02202284 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: A-2567462 . This is a "OXFORD PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: G-53691 . This is a "BC/BS PROVIDE #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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