Provider Demographics
NPI:1093217911
Name:ORTHOTIC SERVICES FOR CHILDREN, INC.
Entity Type:Organization
Organization Name:ORTHOTIC SERVICES FOR CHILDREN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGINO
Authorized Official - Suffix:
Authorized Official - Credentials:CPO CPED
Authorized Official - Phone:718-338-1904
Mailing Address - Street 1:811A CARMAN AVE.
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590
Mailing Address - Country:US
Mailing Address - Phone:718-338-1904
Mailing Address - Fax:718-258-1122
Practice Address - Street 1:811A CARMAN AVE.
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590
Practice Address - Country:US
Practice Address - Phone:718-338-1904
Practice Address - Fax:718-258-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty