Provider Demographics
NPI:1508862665
Name:NEW ENGLAND BRACE COMPANY, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND BRACE COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUIMOND
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:603-668-8360
Mailing Address - Street 1:224 ROUTE 108
Mailing Address - Street 2:UNIT A
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878
Mailing Address - Country:US
Mailing Address - Phone:603-692-9250
Mailing Address - Fax:603-692-9251
Practice Address - Street 1:224 ROUTE 108
Practice Address - Street 2:UNIT A
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-6513
Practice Address - Country:US
Practice Address - Phone:603-692-9250
Practice Address - Fax:603-692-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME138580005Medicaid
VT1002782Medicaid
NH57404OtherCIGNA
NH12Y004914NH01OtherBCBS
NH700383OtherHARVARD PILGRIM
NH30762502Medicaid
NH0340890009Medicare ID - Type Unspecified