Organization
MARK GOLDBERG PROSTHETIC & ORTHOTIC LABS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA RYAN GOLDBERG (OPERATIONS MANAGER)
(631) 689-6606
Entity
Organization
Contact information
Practice address
205 N BELLE MEAD RD STE 150, EAST SETAUKET, NY 11733-3483
(631) 689-6606
(631) 941-3525
Mailing address
205 N BELLE MEAD RD STE 150, EAST SETAUKET, NY 11733-3483
(631) 689-6606
(631) 941-3525
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0107718
—
NY
Enumeration date
11/02/2007
Last updated
02/17/2023
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