Provider Demographics
NPI:1740463686
Name:METROPOLITAN BRACE & LIMB LLC
Entity type:Organization
Organization Name:METROPOLITAN BRACE & LIMB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPO
Authorized Official - Phone:718-824-3595
Mailing Address - Street 1:87 N INDUSTRY CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-4608
Mailing Address - Country:US
Mailing Address - Phone:631-400-3355
Mailing Address - Fax:631-940-8022
Practice Address - Street 1:87 N INDUSTRY CT
Practice Address - Street 2:SUITE C
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-4608
Practice Address - Country:US
Practice Address - Phone:631-400-3355
Practice Address - Fax:631-940-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier