Provider Demographics
NPI:1366829988
Name:MPIRIE LLC
Entity Type:Organization
Organization Name:MPIRIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELLEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-869-0400
Mailing Address - Street 1:1660 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-4239
Mailing Address - Country:US
Mailing Address - Phone:518-209-7178
Mailing Address - Fax:
Practice Address - Street 1:1660 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4239
Practice Address - Country:US
Practice Address - Phone:518-209-7178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier