# NORTHEAST ORTHOTICS & PROSTHETICS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124399084
- **Authorized official:** MARK STEVEN MARICH CPO (OWNER)
- **Authorized official phone:** (401) 437-8016

## Contact information

- **Practice address:** 765 ALLENS AVE, SUITE 250, PROVIDENCE, RI 02905-5443
- **Practice address phone:** (401) 437-8016
- **Practice address fax:** (401) 437-8923
- **Mailing address:** 765 ALLENS AVE, SUITE 250, PROVIDENCE, RI 02905-5443
- **Mailing address phone:** (401) 437-8016
- **Mailing address fax:** (401) 437-8923

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335E00000X | Prosthetic/Orthotic Supplier | CO00011 | RI | — |
| 335E00000X | Prosthetic/Orthotic Supplier | CPO00018 | RI | Yes |

## Other

- **Enumeration date:** 01/24/2012
- **Last updated:** 11/09/2012