Provider Demographics
NPI:1144389404
Name:TRUE DESIGN PROSTHETICS & ORTHOTICS INC.
Entity Type:Organization
Organization Name:TRUE DESIGN PROSTHETICS & ORTHOTICS INC.
Other - Org Name:SAME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFEID ORTHOTIST,BOC PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:CO,BOCOP
Authorized Official - Phone:914-968-1370
Mailing Address - Street 1:70 SMART AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1066
Mailing Address - Country:US
Mailing Address - Phone:914-968-1370
Mailing Address - Fax:914-968-1371
Practice Address - Street 1:70 SMART AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704
Practice Address - Country:US
Practice Address - Phone:914-968-1370
Practice Address - Fax:914-968-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02653749Medicaid
NY4948870001Medicare NSC