Provider Demographics
NPI:1053575431
Name:GENERAL ORTHOPEDIC INC
Entity type:Organization
Organization Name:GENERAL ORTHOPEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SMUCKLER
Authorized Official - Suffix:
Authorized Official - Credentials:C-PED
Authorized Official - Phone:518-869-0021
Mailing Address - Street 1:1659 CENTRAL AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4039
Mailing Address - Country:US
Mailing Address - Phone:518-869-0021
Mailing Address - Fax:518-464-9160
Practice Address - Street 1:1659 CENTRAL AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4039
Practice Address - Country:US
Practice Address - Phone:518-869-0021
Practice Address - Fax:518-464-9160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01534683Medicaid
NY01534683Medicaid