Provider Demographics
NPI:1336145994
Name:CAYUGA ORTHOTICS & PROSTHETICS, INC.
Entity Type:Organization
Organization Name:CAYUGA ORTHOTICS & PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CERT PROSTHETIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RYAN TRENCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:585-482-4558
Mailing Address - Street 1:1583 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7008
Mailing Address - Country:US
Mailing Address - Phone:585-482-4558
Mailing Address - Fax:585-482-7887
Practice Address - Street 1:1583 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7008
Practice Address - Country:US
Practice Address - Phone:585-482-4558
Practice Address - Fax:585-482-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBKOtherEXCELLUS BC/BS
NYPO17005971OtherBLUE CHOICE-EXCELLUS
NY00446204Medicaid
NYBKOtherEXCELLUS BC/BS