Organization
MID-ATLANTIC PROSTHETICS-EAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LONGO (OWNER)
(301) 987-9113
Entity
Organization
Contact information
Practice address
1023 N CHARLES ST STE R3N, BALTIMORE, MD 21201-5410
(240) 401-8063
(667) 210-2167
Mailing address
1023 N CHARLES ST STE R3N, BALTIMORE, MD 21201-5410
(240) 401-8063
(667) 210-2167
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040028800
—
DC
05
—
416699000
—
MD
05
—
5412838 00
—
MD
Enumeration date
07/13/2007
Last updated
06/13/2023
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