JAN PEDERSEN
NPI 1104007442
Prosthetic/Orthotic Supplier in West Sand Lake, NY

Q: What is Jan Pedersen's NPI number?

The NPI number for Jan Pedersen is 1104007442. It was assigned to this organization in the NPPES registry on November 15, 2007.

Q: What is Jan Pedersen's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

Q: When was this NPI record last updated?

The NPPES record for Jan Pedersen was last updated on November 15, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2007

23 ALGONQUIN RD, WEST SAND LAKE, NY 12196(518) 674-3361(518) 674-8320 Get Directions Write a Review

NPPES record last updated: November 15, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jan Pedersen NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAN PEDERSEN (NPI 1104007442) is a healthcare organization registered as a prosthetic/orthotic supplier in West Sand Lake, New York and active in the NPI registry since November 2007. The organization lists Jan Pedersen, Owner, as its authorized official.

NPPES Registry Identity

NPI1104007442

Entity TypeOrganization

Primary Taxonomy335E00000X

Legal Business NameJAN PEDERSEN

Location Address23 ALGONQUIN RDWest Sand Lake, NY 12196-2000

Mailing Address23 Algonquin RdWest Sand Lake, NY 12196-2000 · (518) 674-3361 · Fax (518) 674-8320

Phone(518) 674-3361

Fax(518) 674-8320

Organization SubpartNo

Authorized OfficialJan PedersenOwner · (518) 674-3361

Enumeration DateNovember 15, 2007

✔ NPI 1104007442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers

Taxonomy Code335E00000X

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.

23 ALGONQUIN RD, West Sand Lake, NY 12196

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Other Identifiers 2

Medicaid01755577NY

Medicare NSC4483480001NY

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JAN PEDERSEN BOCO ORTHOTIST

Prosthetic/Orthotic Supplier

23 ALGONQUIN RD
WEST SAND LAKE, NY 12196

Rensselaer County (518) 674-3361

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jan Pedersen's NPI number?

The NPI number for Jan Pedersen is 1104007442. It was assigned to this organization in the NPPES registry on November 15, 2007.

Where is Jan Pedersen located?

Jan Pedersen is located at 23 Algonquin Rd, West Sand Lake, NY 12196. The listed phone number is (518) 674-3361.

What is Jan Pedersen's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Jan Pedersen was last updated on November 15, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.