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Organization
EASTSIDE ORTHOTICS & PROSTHETICS INC
Active
Organization
EASTSIDE ORTHOTICS & PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW D FLYNN CP (PRESIDENT)
(631) 727-8735
Entity
Organization
Contact information
Practice address
26 PALMERS HILL RD, RM 1000, STAMFORD, CT 06902-2113
(203) 975-9004
(203) 975-9008
Mailing address
34 COMMERCE DR, STE 200, RIVERHEAD, NY 11901-3118
(631) 727-8735
(631) 727-6834
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004240652
—
CT
Enumeration date
06/13/2005
Last updated
06/05/2008
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