Provider Demographics
NPI:1720511934
Name:UNITED PROSTHETICS INC
Entity Type:Organization
Organization Name:UNITED PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-436-6110
Mailing Address - Street 1:300 CONGRESS ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0907
Mailing Address - Country:US
Mailing Address - Phone:617-436-6110
Mailing Address - Fax:
Practice Address - Street 1:300 CONGRESS ST
Practice Address - Street 2:SUITE 404
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0907
Practice Address - Country:US
Practice Address - Phone:617-436-6110
Practice Address - Fax:617-436-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier