Advance Prosthetic and Orthotic Inc

Primary specialty

ProsthetistTaxonomy code 224P00000X

Legal business name

ADVANCE PROSTHETIC AND ORTHOTIC INC

Practice address

111 Dean Dr
Tenafly, NJ 07670-2764

Phone

(201) 429-6960

Fax

(201) 429-6961

NPI assigned

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Mathews Mancha

Title

Director

Phone

(201) 317-3443

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1750844239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 CURTMANTLE RD",
            "city": "MICKLETON",
            "state": "NJ",
            "postal_code": "080561263",
            "telephone_number": "201-317-3442",
            "fax_number": "201-353-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEAN DR",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702764",
            "telephone_number": "201-429-6960",
            "fax_number": "201-429-6961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PROSTHETIC AND ORTHOTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "MANCHA",
        "authorized_official_first_name": "MATHEWS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-317-3443",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetist in Tenafly, NJ
• Providers in Tenafly, NJ by specialty
• Prosthetist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.