Organization
ORTHOTICPRO,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN BURGOS BOCP,BOCO (PRESIDENT/OWNER)
(917) 256-9049
Entity
Organization
Contact information
Practice address
380 N BROADWAY APT C2, YONKERS, NY 10701-2064
(917) 256-9049
Mailing address
PO BOX 1195, NEW YORK, NY 10002-0916
(917) 256-9049
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
C50803
NY
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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