Organization
PANKOW ORTHOTICS & PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES E. PANKOW BS,CPO (OWNER)
(716) 651-0660
Entity
Organization
Contact information
Practice address
5489 BROADWAY ST, LANCASTER, NY 14086-2219
(716) 651-0660
(716) 651-0668
Mailing address
5489 BROADWAY, LANCASTER, NY 14086
(716) 651-0660
(716) 651-0668
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00011248701
UNIVERA
NY
05
—
02804002
—
NY
01
—
2908794
INDEPENDENT HEALTH
NY
01
—
5510441
BLUE CROSS BLUE SHIELD
NY
Enumeration date
12/12/2006
Last updated
09/02/2021
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