Monack Medical Supply, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

4192 C21614 Issued in NY

Legal business name

MONACK MEDICAL SUPPLY, INC

Doing business as

Omni Orthotics and Prosthetics

Practice address

1651 Coney Island Ave
Brooklyn, NY 11230-5849

Phone

(888) 343-6664

NPI assigned

Apr 25, 2017

Last updated

Apr 25, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Peter Affenita

Title

President

Phone

(888) 343-6664

Specialties & licenses 1

Addresses

Other names 1

• OMNI ORTHOTICS AND PROSTHETICS Doing business as

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493078400000",
    "number": "1053846253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "888-343-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 CONEY ISLAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305849",
            "telephone_number": "888-343-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONACK MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A",
        "authorized_official_last_name": "AFFENITA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "888-343-6664"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NY",
            "license": "4192  C21614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMNI ORTHOTICS AND PROSTHETICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Brooklyn, NY
• Providers in Brooklyn, 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 Apr 25, 2017; 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.