Provider Demographics
NPI:1710170188
Name:PROSTHETIC & ORTHOTIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PROSTHETIC & ORTHOTIC ASSOCIATES, INC.
Other - Org Name:M&M PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PASSERO
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:845-956-0001
Mailing Address - Street 1:4 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4064
Mailing Address - Country:US
Mailing Address - Phone:845-956-0001
Mailing Address - Fax:
Practice Address - Street 1:103 HURLEY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2829
Practice Address - Country:US
Practice Address - Phone:845-339-4775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0248910002Medicare NSC