Provider Demographics
NPI:1699785550
Name:ORTHOCRAFT INC.
Entity type:Organization
Organization Name:ORTHOCRAFT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERSCHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAUBER
Authorized Official - Suffix:
Authorized Official - Credentials:CO, LPO
Authorized Official - Phone:718-951-1700
Mailing Address - Street 1:1477 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5308
Mailing Address - Country:US
Mailing Address - Phone:718-951-1700
Mailing Address - Fax:
Practice Address - Street 1:2220 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4516
Practice Address - Country:US
Practice Address - Phone:718-951-1700
Practice Address - Fax:718-951-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1234267332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01542552Medicaid
NY01542552Medicaid