Provider Demographics
NPI:1356551980
Name:DM ORTHOTIC & PROSTHETIC, INCC
Entity type:Organization
Organization Name:DM ORTHOTIC & PROSTHETIC, INCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-242-1649
Mailing Address - Street 1:12 UNITY COURT
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NE
Mailing Address - Zip Code:11767
Mailing Address - Country:US
Mailing Address - Phone:516-242-1649
Mailing Address - Fax:631-224-2672
Practice Address - Street 1:24-12 150 TH STREET
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:718-762-4582
Practice Address - Fax:718-762-4592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier