Provider Demographics
NPI:1558832006
Name:TRIAD ORTHOTICS AND PROSTHETICS INC
Entity Type:Organization
Organization Name:TRIAD ORTHOTICS AND PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-886-1419
Mailing Address - Street 1:29 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1512
Mailing Address - Country:US
Mailing Address - Phone:973-886-1419
Mailing Address - Fax:973-301-0899
Practice Address - Street 1:29 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:CHATHAM TWP
Practice Address - State:NJ
Practice Address - Zip Code:07928-1512
Practice Address - Country:US
Practice Address - Phone:973-886-1419
Practice Address - Fax:973-301-0899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies