Prosthetic Rehabilitation Center

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

PROSTHETIC REHABILITATION CENTER

Practice address

2 Winding LN
Newburgh, NY 12550-2223

Phone

(845) 565-8255

Fax

(845) 565-4409

NPI assigned

Aug 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew C Carubia, CPO

Title

Owner

Phone

(845) 565-8255

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023029055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WINDING LN",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502223",
            "telephone_number": "845-565-8255",
            "fax_number": "845-565-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WINDING LN",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125502223",
            "telephone_number": "845-565-8255",
            "fax_number": "845-565-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHETIC REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARUBIA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "845-565-8255",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01148407",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "G54151",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Prosthetic/Orthotic Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.