Provider Demographics
NPI:1366032476
Name:PROSTHETICS LAB LTD LLC
Entity Type:Organization
Organization Name:PROSTHETICS LAB LTD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:YARMISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-837-9447
Mailing Address - Street 1:1115 CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-2728
Mailing Address - Country:US
Mailing Address - Phone:917-837-9447
Mailing Address - Fax:
Practice Address - Street 1:1115 CLARKSON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-2728
Practice Address - Country:US
Practice Address - Phone:917-837-9447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier