Provider Demographics
NPI:1972046241
Name:US ORTHO FITTING
Entity Type:Organization
Organization Name:US ORTHO FITTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:G
Authorized Official - Last Name:TADROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-998-9071
Mailing Address - Street 1:1810 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-0730
Mailing Address - Country:US
Mailing Address - Phone:201-432-2110
Mailing Address - Fax:201-432-2011
Practice Address - Street 1:1810 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305
Practice Address - Country:US
Practice Address - Phone:201-432-2110
Practice Address - Fax:201-432-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier