Provider Demographics
NPI:1346265212
Name:ACADEMY ORTHOTIC & PROSTHETIC ASSOCIATES IPA
Entity Type:Organization
Organization Name:ACADEMY ORTHOTIC & PROSTHETIC ASSOCIATES IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-686-3521
Mailing Address - Street 1:2810 MORRIS AVENUE, SUITE #206
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-686-3521
Mailing Address - Fax:908-686-3575
Practice Address - Street 1:450 WESTMINSTER ROAD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218
Practice Address - Country:US
Practice Address - Phone:908-686-3521
Practice Address - Fax:908-686-3575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier