GREAT LAKES ORTHOPEDIC LABS, INC (NPI# 1245318278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245318278 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES ORTHOPEDIC LABS, INC |
| Practice Address |
1031 Main St Buffalo NY 14203-1014 |
| Practice Telephone | 7168934116 |
| Practice Fax Number | 7168972110 |
| Mailing Telephone | 7168934116 |
| Mailing Fax Number | 7168972110 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-01-08 |
| Authorized Official Name | MR. THOMAS J DALEY (VICE PRESIDENT) |
| Authorized Official Telephone | 7168934116 |
| Authorized Official Credential | CERTIFIED ORTHOT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | FIDELIS CARE NEW YORK | 040401000151 | 01 |
| NY | INDEPENDENT HEALTH ASSOCI | 8207649 | 01 |
| NY | UNIVERA HEALTHCARE | 00011212601 | 01 |
| NY | BLUE CROSS & BLUE SHIELD | 000551033001 | 01 |
| Street Address |
1031 MAIN ST |
| City | BUFFALO |
| State | NY |
| Zip Code | 14203-1014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164539938 | Associated Healthcare Pharmacy | Pharmacy | 1031 Main St, Buffalo, NY 14203-1014 | 2006-08-25 |
| 1578798831 | Henry J. Jarocha | Pharmacist | 1031 Main St, Buffalo, NY 14203-1014 | 2009-05-15 |
| 1134286966 | Associated Healthcare Systems Inc | Pharmacy | 1031 Main St, Buffalo, NY 14203-1014 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912514902 | Valerie Anne Conley | Counselor | 475 Elllicott St., Buffalo, NY 14203 | 2020-09-24 |
| 1457975674 | Qing Ma | Pharmacist | Nys Center of Excellence In Bioinformatics and Life Sci, 701 Ellicott Street, Buffalo, NY 14203 | 2020-06-03 |
| 1265056659 | Elizabeth Nicole Mancuso | Student in an Organized Health Care Education/Training Program | 1001 Main Street University At Buffalo, Department of P, 5th Floor, Buffalo, NY 14203 | 2020-06-02 |
| 1720601404 | Ronak Dhiraj Bahuva | Student in an Organized Health Care Education/Training Program | 955 Main Street, University At Buffalo, Jacobs School O, Buffalo, NY 14203 | 2020-05-28 |
| 1780207266 | Jaya Mishra | Student in an Organized Health Care Education/Training Program | 818 Ellicot Street, Buffalo, NY 14203 | 2020-05-19 |
| 1013530617 | Amanpreet Kaur Singh | Student in an Organized Health Care Education/Training Program | 77 Goodell Street Department of Medicine, Suite 240, Buffalo, NY 14203 | 2020-05-19 |
| 1013538917 | Leen Hosam Alyacoub | Student in an Organized Health Care Education/Training Program | 100 High Street, D2-76 Buffalo, Ny 14203, Buffalo Gener, Buffall, NY 14203 | 2020-05-01 |
| 1003436601 | Maxiam Dean | Student in an Organized Health Care Education/Training Program | Ub Family Residency Program, 77 Goodell Street, 2nd Floor, Buffalo, NY 14203 | 2020-04-23 |
| 1144849837 | Jennifer Anthone-kloss | Student in an Organized Health Care Education/Training Program | Anesthesiology Residency & Fellowship Programs, Ub Gateway, 77 Goodell Street, Suite 550, Buffalo, NY 14203 | 2020-04-13 |
| 1821658873 | Peter William Ip Fung Chun | Student in an Organized Health Care Education/Training Program | 1001 Main Street, Room 5145, Division of Pediatric Medical Education, Buffalo, NY 14203 | 2019-06-20 |
| Find all providers in zip 14203 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033461322 | Rebound Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 300 Catlin St Ste 104, Buffalo, MN 55313-2035 | 2012-10-10 |
| 1306953930 | Buffalo Orthotics & Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 112 1st St S, Buffalo, MN 55313-1402 | 2006-08-23 |
| 1770767659 | Robert A. Hewson D.p.m. | Prosthetic/Orthotic Supplier | 344 Niagara Falls Blvd, Buffalo, NY 14223-3044 | 2007-12-27 |
| 1992735781 | American Health Care Inc | Prosthetic/Orthotic Supplier | 4039 Genesee St, Buffalo, NY 14225-1904 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538796545 | Ffh Concepts LLC | Prosthetic/Orthotic Supplier | 545 Saw Mill River Rd Ste 1a, Ardsley, NY 10502-2159 | 2020-03-27 |
| 1417584046 | Alta Vista Inc. | Prosthetic/Orthotic Supplier | 420 Madison Ave Fl 2, New York, NY 10017-1195 | 2020-03-24 |
| 1114554904 | Britica Management Group Inc | Prosthetic/Orthotic Supplier | 40 Gardenville Pkwy Ste 200, West Seneca, NY 14224-1399 | 2020-03-24 |
| 1992332837 | Genesis II Hair Replacement Studio | Prosthetic/Orthotic Supplier | 405 E Taft Rd, North Syracuse, NY 13212-3734 | 2020-03-23 |
| 1548895113 | East Coast Orthotic & Prosthetic Corp. | Prosthetic/Orthotic Supplier | 326 2nd Ave, New York, NY 10003-2732 | 2020-03-04 |
| 1154964955 | Northern Orthopedic Laboratory Inc. | Prosthetic/Orthotic Supplier | 6604 State Highway 56 Apt 6, Potsdam, NY 13676-3546 | 2019-10-24 |
| 1285275354 | Chanta Mabry | Prosthetic/Orthotic Supplier | 1787 Fulton St, Brooklyn, NY 11233-3029 | 2019-09-30 |
| 1659921716 | Millenium Medical Products, Inc | Prosthetic/Orthotic Supplier | 204 19 12th Ave, Rockaway Point, NY 11697-1120 | 2019-09-19 |
| 1700435278 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 200 Old Country Rd Ste 590a, Mineola, NY 11501-4235 | 2019-09-08 |
| 1265081731 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1393 Veterans Memorial Hwy Ste 112n, Hauppauge, NY 11788-3066 | 2019-09-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.