Provider Demographics
NPI:1003002973
Name:BUFFALO ORTHOPEDIC BRACE, INC.
Entity Type:Organization
Organization Name:BUFFALO ORTHOPEDIC BRACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCAVONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-3344
Mailing Address - Street 1:6140 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-1536
Mailing Address - Country:US
Mailing Address - Phone:716-681-1000
Mailing Address - Fax:716-681-5999
Practice Address - Street 1:6140 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1536
Practice Address - Country:US
Practice Address - Phone:716-681-1000
Practice Address - Fax:716-681-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00011202701OtherUNIVERA
NY8290434OtherINDEPENDENT HEALTH
NY00011202701OtherUNIVERA