Organization
DELTA ORTHOPEDIC LAB., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GBOLAHAN L SASONA CPO, LPO (PRESIDENT)
(201) 222-7777
Entity
Organization
Contact information
Practice address
1010 SUMMIT AVE, JERSEY CITY, NJ 07307-3519
(201) 222-7777
(201) 222-7740
Mailing address
1010 SUMMIT AVE, JERSEY CITY, NJ 07307-3519
(201) 222-7777
(201) 222-7740
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
45PO00000400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3444601
—
NJ
Enumeration date
02/01/2007
Last updated
10/03/2012
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