Provider Demographics
NPI:1235134586
Name:NEW ENGLAND BRACE CO., INC.
Entity Type:Organization
Organization Name:NEW ENGLAND BRACE CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUIMOND
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:603-668-8360
Mailing Address - Street 1:15 NELSON ST.
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2706
Mailing Address - Country:US
Mailing Address - Phone:603-668-8322
Mailing Address - Fax:603-668-2468
Practice Address - Street 1:15 NELSON ST.
Practice Address - Street 2:UNIT 1
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2706
Practice Address - Country:US
Practice Address - Phone:603-668-8322
Practice Address - Fax:603-668-2468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80009456Medicaid
NH4696OtherCIGNA
NH700383OtherHARVARD PILGRIM
NH1201424Y0NH01OtherBCBS
ME138580002Medicaid
VT1002782Medicaid
NH80009456Medicaid