Provider Demographics
NPI:1851599443
Name:MUTUAL ORTHOPEDICS CO., INC.
Entity Type:Organization
Organization Name:MUTUAL ORTHOPEDICS CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHEAL
Authorized Official - Last Name:TUFANO
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:631-265-4444
Mailing Address - Street 1:1767 VETERANS HWY STE 42
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1536
Mailing Address - Country:US
Mailing Address - Phone:631-265-4444
Mailing Address - Fax:631-265-4580
Practice Address - Street 1:702 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-499-4535
Practice Address - Fax:718-499-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02926676Medicaid
NY0214410002Medicare NSC