Organization
PROGRESSIVE ORTHOTICS LTD
Active
Organization
PROGRESSIVE ORTHOTICS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE B GOODMAN CO BOCP (CEO)
(631) 732-5556
Entity
Organization
Contact information
Practice address
285 SILLS RD, SUITE 8C, PATCHOGUE, NY 11772
(631) 447-3860
Mailing address
285 SILLS ROAD, SUITE 8C, PATCHOGUE, NY 11772
(631) 447-3860
(631) 447-6050
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00615045
—
NY
Enumeration date
08/20/2007
Last updated
08/20/2007
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