Provider Demographics
NPI:1306869136
Name:ENESLOW PEDORTHIC ENTERPRISES INC
Entity type:Organization
Organization Name:ENESLOW PEDORTHIC ENTERPRISES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPED
Authorized Official - Phone:212-477-2300
Mailing Address - Street 1:470 PARK AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6819
Mailing Address - Country:US
Mailing Address - Phone:212-477-2300
Mailing Address - Fax:212-477-2156
Practice Address - Street 1:470 PARK AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6819
Practice Address - Country:US
Practice Address - Phone:212-477-2300
Practice Address - Fax:212-477-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
NY1134201332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0179360001Medicare ID - Type Unspecified