Organization
ADVANCED ORTHOTICS & PROSTHETICS , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL V BOLTON CO (CO-OWNER)
(518) 279-4422
Entity
Organization
Contact information
Practice address
950 HOOSICK RD, TROY, NY 12180-6635
(518) 279-4422
(518) 279-0033
Mailing address
950 HOOSICK RD, TROY, NY 12180-6635
(518) 279-4422
(518) 279-0033
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00040246000
BLUE SHIELD NENY
NY
01
—
10052506
CDPHP
NY
01
—
52371
GHI HMO
NY
01
—
600337
MVP
NY
01
—
7104270
AETNA
NM
01
—
G72541
EMPIRE BC/BS
NY
Enumeration date
03/02/2006
Last updated
08/04/2008
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