# PEDIATRIC ORTHOTIC AND PROSTHETIC SERVICES-NORTHEAST,LLC

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

## Provider details

- **NPI number:** 1902208945
- **Authorized official:** MR. BROCK MCCONKEY MS, CPO (MANAGER)
- **Authorized official phone:** (413) 735-1223

## Contact information

- **Practice address:** 516 CAREW ST, SPRINGFIELD, MA 01104-2330
- **Practice address phone:** (413) 735-1223
- **Practice address fax:** (413) 735-1214
- **Mailing address:** PO BOX 947109, ATLANTA, GA 30394-7109
- **Mailing address phone:** (813) 367-2876
- **Mailing address fax:** (813) 518-7659

## Taxonomy

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

## Other

- **Enumeration date:** 09/22/2014
- **Last updated:** 04/23/2025