NPI 1710161773

Peter J Kazanovicz

Organisation Prosthetic/Orthotic Supplier Portland, ME

Practice location

Address: 1685 Congress Street, Portland, ME 04102-2776
Phone: (207) 772-1467
Fax: (603) 644-2354
Mailing address: 169 S River Rd Unit 14a, Bedford, NH 03110-6971

Authorised official

Name: Peter J Kazanovicz
Title: Board Certified Ocularist/Owner
Phone: (603) 622-5200

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X

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Registry record

NPI: 1710161773
Entity type: Organization
NPI issued: 26 Dec 2007
Record last updated: 30 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.