Provider Demographics
NPI:1437661493
Name:ORTHOBODY MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:ORTHOBODY MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:C
Authorized Official - Last Name:VILLA-TINEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-409-2876
Mailing Address - Street 1:629 W 185TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3102
Mailing Address - Country:US
Mailing Address - Phone:917-409-2876
Mailing Address - Fax:
Practice Address - Street 1:629 W 185TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3102
Practice Address - Country:US
Practice Address - Phone:917-409-2876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-31
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier