Organization
GIBRALTAR ORTHOTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SCISCENTE C.O. (VICE PRESIDENT ABC CERTIFIED OFFICE)
(845) 620-1188
Entity
Organization
Contact information
Practice address
91 E CENTRAL AVE, PEARL RIVER, NY 10965
(845) 620-1188
(845) 620-1180
Mailing address
91 E CENTRAL AVE, PEARL RIVER, NY 10965
(845) 620-1188
(845) 620-1180
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
0000036680
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00978845
—
NY
Enumeration date
04/14/2006
Last updated
01/22/2020
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