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Jan Pedersen
Prosthetic/Orthotic Supplier in West Sand Lake, New York
NPI 1104007442

Jan Pedersen is a Prosthetic/Orthotic Supplier based in West Sand Lake, NY. Jan Pedersen practices in West Sand Lake, NY. The NPI Number for Jan Pedersen is 1104007442 and holds a License No. (New York).

The current practice location address for Jan Pedersen is 23 Algonquin Rd, West Sand Lake, NY and can be reached out via phone at 518-674-3361 and via fax at 518-674-8320.

Location: 23 Algonquin Rd, West Sand Lake, NY, 12196-2000
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1104007442
Provider Name
Jan Pedersen
Credential
Provider Entity Type
Organization
Address
23 Algonquin Rd, West Sand Lake, NY, 12196-2000
Phone Number
518-674-3361
Fax Number
518-674-8320
Provider Enumeration Date
11/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01755577 05 NY
institution
Provider Business Practice Location Address Details
Address
23 Algonquin Rd
City
West Sand Lake
State
New York
Zip
12196-2000
Phone Number
518-674-3361
Fax Number
518-674-8320
person
Provider Business Mailing Address Details
Address
23 Algonquin Rd
City
West Sand Lake
State
New York
Zip
12196-2000
Phone Number
518-674-3361
Fax Number
518-674-8320
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
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.
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