Provider Demographics
NPI:1598559932
Name:BG BRACING, LLC
Entity type:Organization
Organization Name:BG BRACING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIYKA
Authorized Official - Middle Name:
Authorized Official - Last Name:D'AGOSTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-494-6336
Mailing Address - Street 1:84 HOPPER AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1245
Mailing Address - Country:US
Mailing Address - Phone:973-494-6336
Mailing Address - Fax:973-341-7791
Practice Address - Street 1:84 HOPPER AVE
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1245
Practice Address - Country:US
Practice Address - Phone:973-494-6336
Practice Address - Fax:973-341-7791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies