Provider Demographics
NPI:1659381226
Name:MANHASSET ORTHOTICS PROSTHETICS LTD
Entity Type:Organization
Organization Name:MANHASSET ORTHOTICS PROSTHETICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CPO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LENZE
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:516-938-6639
Mailing Address - Street 1:7 NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-938-6637
Mailing Address - Fax:516-938-6689
Practice Address - Street 1:7 NEWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-938-6637
Practice Address - Fax:516-938-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00370278Medicaid
NY0384120001Medicare ID - Type Unspecified