EASTSIDE ORTHOTICS AND PROSTHETICS, INC. (NPI# 1982608493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982608493 |
| Entity Type | Organization |
| Organization Name | EASTSIDE ORTHOTICS AND PROSTHETICS, INC. |
| Practice Address |
622 W 168th St Vc333 New York NY 10032 |
| Mailing Address |
34 Commerce Dr Suite 200 Riverhead NY 11901-3174 |
| Practice Telephone | 2123053275 |
| Practice Fax Number | 2123055927 |
| Mailing Telephone | 6317278735 |
| Mailing Fax Number | 6317276834 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2007-09-19 |
| Authorized Official Name | MR. MATTHEW D FLYNN (PRESIDENT) |
| Authorized Official Telephone | 6317278735 |
| Authorized Official Credential | CP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01052611 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | EASTSIDE ORTHOTICS AND PROSTHETICS, INC. | 17316 Ne Halsey St, Portland, OR 97230 |
| Street Address |
622 W 168TH ST VC333 |
| City | NEW YORK |
| State | NY |
| Zip Code | 10032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386399 | Carl Elliston | Radiology | 622 W 168th St, Department of Radiation Oncology, New York, NY 10032 | 2020-11-02 |
| 1275140758 | Alyssa Hope Diaz | Nurse Practitioner | 622 W 168th St, New York, NY 10032-3720 | 2020-09-28 |
| 1295341873 | Ann Mchugh | Obstetrics & Gynecology | 622 W 168th St, New York, NY 10032-3720 | 2020-09-19 |
| 1821604778 | Kellie Kolessar | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-09-16 |
| 1912525833 | Fanny Ok | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-07-07 |
| 1982221644 | Ashley D Gandhi | Physician Assistant | 622 W 168th St, New York, NY 10032-3720 | 2020-06-29 |
| 1891311080 | Demond Harrison | Respiratory Therapist, Registered | 622 W 168th St, New York, NY 10032-3720 | 2020-06-23 |
| 1073136115 | Dennis Man | Pharmacist | 622 W 168th St, New York, NY 10032-3720 | 2020-05-23 |
| 1205457801 | Adam Sands | Student in an Organized Health Care Education/Training Program | 622 W 168th St, New York, NY 10032-3720 | 2020-05-05 |
| 1407477102 | Julia Anne Tepper | Student in an Organized Health Care Education/Training Program | 622 W 168th St, New York, NY 10032-3720 | 2020-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658301 | Julia Sophia White | Registered Nurse | 622 W 168th St, New York, Ny, New York, NY 10032 | 2020-10-29 |
| 1326653411 | Simbarashe S Mudiwa | Massage Therapist | 615 W 165th St, Apt 1b, New York, NY 10032 | 2020-09-15 |
| 1063021335 | Margaret E O'neil | Physical Therapist | 180 Fort Washington St, Harkness 1-164, New York, NY 10032 | 2020-07-23 |
| 1780207480 | Bing Mei Teh | Student in an Organized Health Care Education/Training Program | 180 Fort Washington Ave, Harkness Pavillion 7th Floor, Department of Otolaryngology, New York, NY 10032 | 2020-05-28 |
| 1295354116 | Kavin Fatehchand | Student in an Organized Health Care Education/Training Program | 630 West 168th Street, New York, Ny 10032, New York, NY 10032 | 2020-04-10 |
| 1417584020 | Laura Faye Willard | Student in an Organized Health Care Education/Training Program | 177 Ft. Washington Ave., 7gs-313, New York, NY 10032 | 2020-03-24 |
| 1356976641 | Thomas Joseph Cahill | Student in an Organized Health Care Education/Training Program | Columbia Heart & Valve Center, New York Presbyterian/co, 161 Fort Washington Avenue, Herbert Irving Pavilion 6 F, New York City, NY 10032 | 2020-03-06 |
| 1346874765 | Paulo Roberto De Paula Selber | Orthopaedic Surgery | Department of Orthopedic Surgery - Chony, 3959 Broadway, 8 North, Room 803, New York, NY 10032 | 2020-02-25 |
| 1720611312 | Rachel Dawn Vanderlaan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Newyork-presbyterian Morgan Stanley Children's Hospital, 3959 Broadway Ave Suite: 274, New York, NY 10032 | 2020-02-21 |
| 1881225928 | Daniel Molina Garcia | Social Worker | 180 Fort Washingtion Avenue, 6th Fl, New York, NY 10032 | 2020-01-28 |
| Find all providers in zip 10032 | ||||
| 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 |
|---|---|---|---|---|
| 1417584046 | Alta Vista Inc. | Prosthetic/Orthotic Supplier | 420 Madison Ave Fl 2, New York, NY 10017-1195 | 2020-03-24 |
| 1548895113 | East Coast Orthotic & Prosthetic Corp. | Prosthetic/Orthotic Supplier | 326 2nd Ave, New York, NY 10003-2732 | 2020-03-04 |
| 1003393786 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 30 E 40th St Rm 905, New York, NY 10016-1231 | 2018-07-25 |
| 1053763268 | Eschen Prosthetic & Orthotic Laboratories, Inc | Prosthetic/Orthotic Supplier | 601 W 168th St Apt 24, New York, NY 10032-3707 | 2016-07-12 |
| 1679954127 | Empire Prosthetic & Orthotic Designs LLC | Prosthetic/Orthotic Supplier | 37 E 30th St, New York, NY 10016-7313 | 2015-06-10 |
| 1609018225 | American Hand Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 251 E 32nd St, Apt.11a, New York, NY 10016-6304 | 2009-03-27 |
| 1659513554 | Prosthetics In Motion, Inc | Prosthetic/Orthotic Supplier | 3 W 35th St Fl 7, New York, NY 10001-2204 | 2009-03-24 |
| 1992901904 | Progressive Dynamic Designs, Inc. | Prosthetic/Orthotic Supplier | 420 E 82nd St, Suite 1e, New York, NY 10028-5901 | 2007-06-26 |
| 1871717991 | Precision Orthotics & Prosthetics, Inc | Prosthetic/Orthotic Supplier | 303 Fifth Avenue, Suite 511, New York, NY 10016-6686 | 2007-04-12 |
| 1659458040 | Eschen Prosthetic & Orthotic Laboratories, Inc. | Prosthetic/Orthotic Supplier | 510 E 73rd St, Suite 201a, New York, NY 10021-4010 | 2006-11-01 |
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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.