Provider Demographics
NPI:1760487466
Name:ISLAND ORTHOTIC & PROSTHETIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:ISLAND ORTHOTIC & PROSTHETIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIZZUTO
Authorized Official - Suffix:II
Authorized Official - Credentials:CPO
Authorized Official - Phone:516-377-9033
Mailing Address - Street 1:294 W MERRICK RD
Mailing Address - Street 2:STE 10
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3357
Mailing Address - Country:US
Mailing Address - Phone:516-377-9033
Mailing Address - Fax:516-623-9585
Practice Address - Street 1:294 W MERRICK RD
Practice Address - Street 2:STE 10
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3357
Practice Address - Country:US
Practice Address - Phone:516-377-9033
Practice Address - Fax:516-623-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies