1750768867 NPI number — ORTHOTICS & PROSTHETICS 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 1750768867 NPI number — ORTHOTICS & PROSTHETICS LABORATORIES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOTICS & PROSTHETICS 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:
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:
1750768867
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 BIRNIE AVE
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01107-1107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-737-2404
Provider Business Mailing Address Fax Number:
413-733-1389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36 SERVICE CENTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-2575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-585-8622
Provider Business Practice Location Address Fax Number:
413-587-3773
Provider Enumeration Date:
04/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HAAS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
413-737-2404

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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