Provider Demographics
NPI:1548353774
Name:UNITED ORTHOPAEDIC APPLIANCE CO., INC.
Entity type:Organization
Organization Name:UNITED ORTHOPAEDIC APPLIANCE CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-357-9113
Mailing Address - Street 1:325 MERRICK AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1556
Mailing Address - Country:US
Mailing Address - Phone:212-674-2366
Mailing Address - Fax:212-473-0658
Practice Address - Street 1:5713 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5332
Practice Address - Country:US
Practice Address - Phone:212-674-2366
Practice Address - Fax:212-473-0658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332BC3200X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00320172Medicaid
NYA08002123Medicare PIN
NY0201720001Medicare NSC