Provider Demographics
NPI:1679818652
Name:ALLCARE ORTHOTIC & PROSTHETIC SERVICES, LLC
Entity Type:Organization
Organization Name:ALLCARE ORTHOTIC & PROSTHETIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-790-9222
Mailing Address - Street 1:2333 MORRIS AVE
Mailing Address - Street 2:SUITE C-210
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5714
Mailing Address - Country:US
Mailing Address - Phone:908-790-9222
Mailing Address - Fax:
Practice Address - Street 1:50 ESSEX ST STE 7
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4341
Practice Address - Country:US
Practice Address - Phone:201-880-6908
Practice Address - Fax:908-688-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0254550Medicaid