Organization
WESTERN NEW YORK ORTHOTIC SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH L. CALABRESE BOC (PRESIDENT)
(716) 881-0499
Entity
Organization
Contact information
Practice address
1275 DELAWARE AVE, SUITE 300, BUFFALO, NY 14209-2412
(716) 881-0499
(716) 884-1128
Mailing address
1275 DELAWARE AVE, SUITE 300, BUFFALO, NY 14209-2412
(716) 881-0499
(716) 884-1128
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00030137201
BLUE CROSS BLUE SHIELD
NY
05
—
02066315
—
NY
01
—
040401000197
FIDELIS PROVIDER ID
NY
01
—
080885
NORTHWOOD PROVIDER ID
NY
01
—
8211684
INDEPENDENT HEALTH ID
NY
05
—
N7A
—
NY
Enumeration date
04/18/2006
Last updated
07/21/2022
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