Provider Demographics
NPI:1073524336
Name:ORTHOWORKS INC
Entity Type:Organization
Organization Name:ORTHOWORKS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEAL
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:LPO
Authorized Official - Phone:516-361-3177
Mailing Address - Street 1:18 JAMES ST S
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-2017
Mailing Address - Country:US
Mailing Address - Phone:212-879-5226
Mailing Address - Fax:516-792-6558
Practice Address - Street 1:2 LAWSON AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1700
Practice Address - Country:US
Practice Address - Phone:212-879-5226
Practice Address - Fax:516-792-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCPO01818332BC3200X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01874437Medicaid
NY01874437Medicaid