Delta Orthopedic Lab., Inc.

Primary specialty

Orthotic FitterTaxonomy code 225000000X

License

45PO00000400 Issued in NJ

Legal business name

DELTA ORTHOPEDIC LAB., INC.

Practice address

1010 Summit Ave
Jersey City, NJ 07307-3519

Phone

(201) 222-7777

Fax

(201) 222-7740

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Gbolahan L Sasona, CPO, LPO

Title

President

Phone

(201) 222-7777

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1235277336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SUMMIT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073073519",
            "telephone_number": "201-222-7777",
            "fax_number": "201-222-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SUMMIT AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073073519",
            "telephone_number": "201-222-7777",
            "fax_number": "201-222-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA ORTHOPEDIC LAB., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "SASONA",
        "authorized_official_first_name": "GBOLAHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-222-7777",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO, LPO"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthotic Fitter",
            "state": "NJ",
            "license": "45PO00000400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3444601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthotic Fitter in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Orthotic Fitter in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.