Provider Demographics
NPI:1538163563
Name:AMKEN ORTHOPEDICS, INC.
Entity type:Organization
Organization Name:AMKEN ORTHOPEDICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:516-933-9255
Mailing Address - Street 1:299 DUFFY AVE
Mailing Address - Street 2:STE B
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3635
Mailing Address - Country:US
Mailing Address - Phone:516-933-9255
Mailing Address - Fax:516-933-4710
Practice Address - Street 1:299 DUFFY AVE
Practice Address - Street 2:STE B
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3635
Practice Address - Country:US
Practice Address - Phone:516-933-9255
Practice Address - Fax:516-933-4710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00320109Medicaid
NY0139280001Medicare ID - Type Unspecified