NPIMap

Organization Active NPI

Pro-Thoticstechnology, Inc

  • Prosthetic/Orthotic Supplier
  • Paterson, NJ
National Provider Identifier
1093193765
Registry record updated May 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
45PO00002800 Issued in NJ
Legal business name
PRO-THOTICSTECHNOLOGY, INC
Doing business as
Prothotics Health
Practice address
714 Broadway
1St Floor
Paterson, NJ 07514-3402
Phone
(877) 776-8400
Fax
(877) 366-5492
NPI assigned
May 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2015

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

Authorized official

Name
John Peter Affenita, CPO
Title
President
Phone
(877) 776-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 45PO00002800 NJ Primary

Addresses

Primary practice location

714 Broadway
1St Floor
Paterson, NJ 07514-3402

Mailing address

285 Sills Rd
BLDG 3 Ste D
East Patchogue, NY 11772-4869
Phone (877) 776-8400

Other names 1

  • Prothotics Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pro-Thotics Technology Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

285 Sills Rd
Bldg 3D
East Patchogue, NY 11772
Phone (631) 438-1075

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1093193765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 SILLS RD",
            "address_2": "BLDG 3 STE D",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724869",
            "telephone_number": "877-776-8400",
            "fax_number": "877-366-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 BROADWAY",
            "address_2": "1ST FLOOR",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075143402",
            "telephone_number": "877-776-8400",
            "fax_number": "877-366-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-THOTICSTECHNOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "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": "877-776-8400",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NJ",
            "license": "45PO00002800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prothotics Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.