Provider Demographics
NPI:1336324086
Name:KONRAD PROSTHETICS AND ORTHOTICS, INC
Entity Type:Organization
Organization Name:KONRAD PROSTHETICS AND ORTHOTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:KONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-485-9164
Mailing Address - Street 1:475 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4135
Mailing Address - Country:US
Mailing Address - Phone:516-292-1180
Mailing Address - Fax:
Practice Address - Street 1:475 FULTON AVE
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4135
Practice Address - Country:US
Practice Address - Phone:516-292-1180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0395790002Medicare NSC