Organization
PROLOG SUPPLY INC
Active
Organization
PROLOG SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATERYNA VICKERS (OWNER)
(917) 789-9502
Entity
Organization
Contact information
Practice address
2714 GERRITSEN AVE, BROOKLYN, NY 11229-5915
(917) 789-9502
Mailing address
2714 GERRITSEN AVE, BROOKLYN, NY 11229-5915
(917) 789-9502
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
11/27/2025
Last updated
11/27/2025
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