Organization
CHOICE LIMB & BRACE
Active
Organization
CHOICE LIMB & BRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J SQUICCIARINI (CPO CRED)
(914) 479-0743
Entity
Organization
Contact information
Practice address
555A S COLUMBUS AVE, MOUNT VERNON, NY 10550-4731
(914) 479-0743
(914) 479-1568
Mailing address
555A S COLUMBUS AVE, MOUNT VERNON, NY 10550-4731
(914) 479-0743
(914) 479-1568
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
1230265
NY
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02215167
—
NY
01
—
412358224
HEALTH PLUS
NY
01
—
A2540663
OXFORD
NY
Enumeration date
12/06/2005
Last updated
08/10/2020
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