Provider Demographics
NPI:1225483043
Name:ORTHOSERVE INC
Entity Type:Organization
Organization Name:ORTHOSERVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAKHANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-882-0717
Mailing Address - Street 1:2987 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2603 WEBSTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-4845
Practice Address - Country:US
Practice Address - Phone:718-618-7503
Practice Address - Fax:718-618-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment