Provider Demographics
NPI:1700324522
Name:SAFESTEP, LLC
Entity Type:Organization
Organization Name:SAFESTEP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, CPED
Authorized Official - Phone:973-945-6827
Mailing Address - Street 1:2905 VETERANS MEMORIAL HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-7655
Mailing Address - Country:US
Mailing Address - Phone:866-712-7837
Mailing Address - Fax:631-392-7133
Practice Address - Street 1:2905 VETERANS MEMORIAL HWY STE 2
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7655
Practice Address - Country:US
Practice Address - Phone:866-712-7837
Practice Address - Fax:631-392-7133
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOTIC HOLDINGS INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-01
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCPED4258335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7616740001OtherMEDICARE NSC