Provider Demographics
NPI:1356649842
Name:L&L ORTHOTICS, LLC
Entity Type:Organization
Organization Name:L&L ORTHOTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-751-3719
Mailing Address - Street 1:45 E HARWOOD TER
Mailing Address - Street 2:UNIT A
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1424
Mailing Address - Country:US
Mailing Address - Phone:347-751-3719
Mailing Address - Fax:
Practice Address - Street 1:629 W 185TH ST
Practice Address - Street 2:BASEMENT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3102
Practice Address - Country:US
Practice Address - Phone:347-751-3719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies