Organization Active NPI

Gibraltar Orthotics Inc

  • Orthotic Fitter
  • Pearl River, NY
National Provider Identifier
1851355994
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthotic FitterTaxonomy code 225000000X
License
0000036680
Legal business name
GIBRALTAR ORTHOTICS INC
Practice address
91 E Central Ave
Pearl River, NY 10965
Phone
(845) 620-1188
Fax
(845) 620-1180
NPI assigned
Apr 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Authorized official

Name
Mr. Daniel Sciscente, C.O.
Title
Vice President Abc Certified Office
Phone
(845) 620-1188

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic FitterGroup: 193400000X SINGLE SPECIALTY GROUP 225000000X 0000036680 Primary

Addresses

Primary practice location

91 E Central Ave
Pearl River, NY 10965

Mailing address

91 E Central Ave
Pearl River, NY 10965
Phone (845) 620-1188

Other practice location 1

1 Alhambra Plz Ph Floor
Coral Gables, FL 33134-5216
Phone (845) 620-1188

Other identifiers 1

IdentifierTypeStateIssuer
00978845MedicaidNY

National Provider Directory

National Provider Directory

Locations

91 E Central Ave
Pearl River, NY 10965
Phone (845) 620-1188

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579651200000",
    "number": "1851355994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "10965",
            "telephone_number": "845-620-1188",
            "fax_number": "845-620-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 E CENTRAL AVE",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "10965",
            "telephone_number": "845-620-1188",
            "fax_number": "845-620-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Alhambra Plz Ph Floor",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331345216",
            "country_code": "US",
            "telephone_number": "845-620-1188",
            "fax_number": "845-620-1180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GIBRALTAR ORTHOTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A",
        "authorized_official_last_name": "SCISCENTE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "VICE PRESIDENT ABC CERTIFIED OFFICE",
        "authorized_official_telephone_number": "845-620-1188",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.O."
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthotic Fitter",
            "state": null,
            "license": "0000036680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00978845",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl River, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.