Eastside Orthotics & Prosthetics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

EASTSIDE ORTHOTICS & PROSTHETICS INC

Practice address

388 Westchester Ave
Ste 1J
Port Chester, NY 10573-3623

Phone

(914) 935-1185

Fax

(914) 935-1187

NPI assigned

Jun 13, 2005

Last updated

Jun 5, 2008By 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

Mr. Matthew D Flynn, CP

Title

President

Phone

(631) 727-8735

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Eastside Orthotics Prosthetics Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Eastside Orthotics & Prosthetics Inc

  • Prosthetic/Orthotic Supplier
  • Stamford, CT
  • NPI 1093719593
  NPD tax ID

Locations

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1568466068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 COMMERCE DR",
            "address_2": "STE 200",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013118",
            "telephone_number": "631-727-8735",
            "fax_number": "631-727-6834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 WESTCHESTER AVE",
            "address_2": "STE 1J",
            "city": "PORT CHESTER",
            "state": "NY",
            "postal_code": "105733623",
            "telephone_number": "914-935-1185",
            "fax_number": "914-935-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE ORTHOTICS & PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-727-8735",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CP"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003104578",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02247914",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esme Marguerite Douglas, DNP, PMHNP-BC
• Dr Denis Leblang DPM PC
• Jacqueline Ivette Duarte, M.D.
• Courtney Jennifer Dumain
• Rebecca Hannah Atlas Dunn, LCSW
• Economy Pharmacy Inc (Cammarato's Economy Pharmacy)
• Victor Lawrence Edmond, D.D.S.
• Katherine B Ensign, OD
• Maria Escaffi
• Jorge Martin Espana, M.D.

• Prosthetic/Orthotic Supplier in Port Chester, NY
• Providers in Port Chester, 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 Jun 5, 2008; 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.