Provider Demographics
NPI:1487688628
Name:SETRON PROSTHETICS & ORTHOTICS CORPERATION
Entity Type:Organization
Organization Name:SETRON PROSTHETICS & ORTHOTICS CORPERATION
Other - Org Name:ALBANY ORTHOPEDIC APPLIANCE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED ORTHOTIST/PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:RUDY
Authorized Official - Last Name:SETZER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:518-456-3221
Mailing Address - Street 1:1781 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-4601
Mailing Address - Country:US
Mailing Address - Phone:518-456-3221
Mailing Address - Fax:518-464-3694
Practice Address - Street 1:1781 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4601
Practice Address - Country:US
Practice Address - Phone:518-456-3221
Practice Address - Fax:518-464-3694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0530OtherMVP HEALTH PLAN
NY10002792OtherCDPHP
NY00385699Medicaid
NY10002792OtherCDPHP