Jan Pedersen

LBN: Jan Pedersen
Jan Pedersen is an health care organization with primary practice located at 23 Algonquin Rd , West Sand Lake NY 12196-2000. The organization recently has only one registered license in Suppliers / Prosthetic/Orthotic Supplier, which is considered as the primary health care specialty. Jan Pedersen can be contacted via phone (518) 674-3361, or through Pedersen, Jan via phone (518) 674-3361.

Contact Information

Primary practice address
23 Algonquin Rd West Sand Lake NY 12196-2000
Phone: (518) 674-3361
Fax: (518) 674-8320
Website:
Map and Directions
Authorized official contact:
Name: Pedersen, Jan ORTHOTIST
Phone: (518) 674-3361

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1104007442
LBN Legal business name Jan Pedersen
DBA Doing business as
Authorized official Pedersen, Jan ORTHOTIST
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2007
Last updated Nov 15th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104007442 NPPES
New York MEDICAID 01755577

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