Organization
NEW YORK ORTHOTIC AND PROSTHETIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IRA MILLER CPO,FAAOP (PRESIDENT)
(516) 466-6751
Entity
Organization
Contact information
Practice address
505 NORTHERN BLVD, GREAT NECK, NY 11021-5101
(516) 466-6751
Mailing address
505 NORTHERN BLVD, GREAT NECK, NY 11021-5101
(516) 466-6751
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
859
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00737884
—
NY
Enumeration date
11/02/2006
Last updated
12/11/2007
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