Provider Demographics
NPI:1831582220
Name:KMY PROSTHETIC & ORTHOTIC INC.
Entity type:Organization
Organization Name:KMY PROSTHETIC & ORTHOTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHETIST/ORTHOTIST
Authorized Official - Prefix:
Authorized Official - First Name:NAJEEBULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, BOCPO
Authorized Official - Phone:559-277-3909
Mailing Address - Street 1:6137 N THESTA ST STE 101B
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8605
Mailing Address - Country:US
Mailing Address - Phone:559-277-3909
Mailing Address - Fax:559-277-3090
Practice Address - Street 1:6137 N THESTA ST STE 101B
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8605
Practice Address - Country:US
Practice Address - Phone:559-277-3909
Practice Address - Fax:559-277-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
MDC50916335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center