Organization
ADVANTAGE ORTHOTICS AND PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CLAIRE ANN KETCHAM CFM (OWNER)
(631) 368-1754
Entity
Organization
Contact information
Practice address
337 LARKFIELD RD, EAST NORTHPORT, NY 11731
(631) 368-1754
(631) 486-4502
Mailing address
337 LARKFIELD RD, EAST NORTHPORT, NY 11731
(631) 368-1754
(631) 486-4502
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1231286
AETNA
NY
01
—
6997140
CIGNA
NY
Enumeration date
10/11/2006
Last updated
08/22/2020
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