Provider Demographics
NPI:1437588175
Name:NEW ENGLAND ORTHOTIC & PROSTHETICS SYSTEMS, LLC
Entity Type:Organization
Organization Name:NEW ENGLAND ORTHOTIC & PROSTHETICS SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGANIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:230-483-8488
Mailing Address - Street 1:22 SUMMIT PL
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-4111
Mailing Address - Country:US
Mailing Address - Phone:203-483-8488
Mailing Address - Fax:203-483-6085
Practice Address - Street 1:51 SHUNPIKE RD STE 41
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-2497
Practice Address - Country:US
Practice Address - Phone:860-635-7653
Practice Address - Fax:860-635-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier