Eastside Orthotics & Prosthetics Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

EASTSIDE ORTHOTICS & PROSTHETICS INC

Practice address

417 E 72ND St
New York, NY 10021-4414

Phone

(212) 326-8501

Fax

(212) 326-8538

NPI assigned

Jun 13, 2005

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 1

Locations

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1851395388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 HARRISON AVE",
            "address_2": "STE 2A",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012090",
            "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": "417 E 72ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214414",
            "telephone_number": "212-326-8501",
            "fax_number": "212-326-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE ORTHOTICS & PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2013-08-12",
        "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": "02247890",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastside Medical Office , PC
• Eastside Medical Practice, P.C.
• Eastside Medical Radiology PLLC
• Eastside Optometric, P.C.
• Eastside Oral Surgery
• Eastside Orthotics and Prosthetics, Inc.
• Eastside Physicians of Nyc, PLLC
• Eastside Physicians of Nyc, PLLC
• Eastside Podiatry Associates, PC
• Eastside Private Diagnostic Imaging PLLC

• Prosthetic/Orthotic Supplier in New York, NY
• Providers in New York, 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 Aug 12, 2013; 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.