Provider Demographics
NPI:1457355976
Name:CARLOW ORTHOPEDIC AND PROSTHETICS, INC
Entity Type:Organization
Organization Name:CARLOW ORTHOPEDIC AND PROSTHETICS, INC
Other - Org Name:NEW ENGLAND ORTHOTIC & PROSTHETICS SYSTEMS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:203-483-8488
Mailing Address - Street 1:16 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-2801
Mailing Address - Country:US
Mailing Address - Phone:203-483-8488
Mailing Address - Fax:203-483-6085
Practice Address - Street 1:1580 PONTIAC AVENUE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4487
Practice Address - Country:US
Practice Address - Phone:401-738-6450
Practice Address - Fax:401-261-8621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW ENGLAND ORTHOTIC & PROSTHETIC SYST.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-13
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0525653OtherAETNA
MA1528157Medicaid
RIB501036OtherCIGNA
RI97037OtherBLUECROSS BLUESHIELD RI
RI8200104OtherUNITED HEALTHCARE
RI200260OtherBLUECHIP
CT003021490Medicaid
RI9009703Medicaid
RI1975Medicaid
1223150001Medicare NSC
RI1975Medicaid