Provider Demographics
NPI:1477631646
Name:TONAWANDA LIMB & BRACE INC
Entity Type:Organization
Organization Name:TONAWANDA LIMB & BRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPANY PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CATIPOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED PROSTHESIS
Authorized Official - Phone:716-695-1131
Mailing Address - Street 1:545 DELAWARE STREET
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150
Mailing Address - Country:US
Mailing Address - Phone:716-695-1131
Mailing Address - Fax:716-695-0016
Practice Address - Street 1:545 DELAWARE STREET
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150
Practice Address - Country:US
Practice Address - Phone:716-695-1131
Practice Address - Fax:716-695-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2952043OtherIHA
NY00552947Medicaid
NY551054001OtherBCBS
NY2952043OtherIHA