Provider Demographics
NPI:1134423312
Name:ADVANCED ORTHOPEDIC EQUIPMENT, INC.
Entity type:Organization
Organization Name:ADVANCED ORTHOPEDIC EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-782-1332
Mailing Address - Street 1:78 MARINA RD
Mailing Address - Street 2:
Mailing Address - City:ISLAND PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11558-1007
Mailing Address - Country:US
Mailing Address - Phone:516-984-6692
Mailing Address - Fax:516-706-1504
Practice Address - Street 1:8931 161ST ST
Practice Address - Street 2:MAIN FLOOR
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6102
Practice Address - Country:US
Practice Address - Phone:718-291-6161
Practice Address - Fax:718-526-6169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004623335E00000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier