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Organization
WESTERN NEW YORK ORTHOTIC SUPPLY, INC.
Active
Organization
WESTERN NEW YORK ORTHOTIC SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH L. CALABRESE BOC (PRESIDENT)
(716) 881-0499
Entity
Organization
Contact information
Practice address
1275 DELAWARE AVE, SUITE 300, BUFFALO, NY 14209-2412
(716) 881-0499
(716) 884-1128
Mailing address
1275 DELAWARE AVE, SUITE 300, BUFFALO, NY 14209-2412
(716) 881-0499
(716) 884-1128
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030137201
BLUE CROSS BLUE SHIELD
NY
05
—
02066315
—
NY
01
—
040401000197
FIDELIS PROVIDER ID
NY
01
—
080885
NORTHWOOD PROVIDER ID
NY
01
—
8211684
INDEPENDENT HEALTH ID
NY
05
—
N7A
—
NY
Enumeration date
04/18/2006
Last updated
07/21/2022
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