| Organization Name: | MBR ORTHOTICS INC |
| NPI Number: | 1053399782 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL BRUCE REBARBER (PRES) |
| Mailing Address: | 579 Goffle Rd Wyckoff |
| State: | NJ US |
| Postal Code: | 074812946 |
| Phone Number: | 2014447750 |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2006 |
| NPI Last Update Date: | 04/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 45PO00005000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |