Provider Demographics
NPI:1003979170
Name:A AND B PROSTHETICS AND ORTHOTICS INC
Entity Type:Organization
Organization Name:A AND B PROSTHETICS AND ORTHOTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:JERRY
Authorized Official - Last Name:VERITY
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED ORTHOTIST
Authorized Official - Phone:516-378-3155
Mailing Address - Street 1:3345 PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-5129
Mailing Address - Country:US
Mailing Address - Phone:516-378-3155
Mailing Address - Fax:516-378-1495
Practice Address - Street 1:2876 MILBURN AVENUE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4235
Practice Address - Country:US
Practice Address - Phone:516-378-3155
Practice Address - Fax:516-378-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00770356Medicaid
0126780001Medicare ID - Type Unspecified