Provider Demographics
NPI:1457337412
Name:MYOBILITY, INC
Entity Type:Organization
Organization Name:MYOBILITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:845-623-1740
Mailing Address - Street 1:231 S MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3370
Mailing Address - Country:US
Mailing Address - Phone:845-623-1740
Mailing Address - Fax:845-623-1802
Practice Address - Street 1:231 S MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3370
Practice Address - Country:US
Practice Address - Phone:845-623-1740
Practice Address - Fax:845-623-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0234300001Medicare NSC