Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Madeline Rose Mastectomy Boutique, LLC

Organization Mastectomy Fitter · NPI 1316693765

Madeline Rose Mastectomy Boutique, LLC is a Mastectomy Fitter in Vestal, New York. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

100 Rano Blvd
Vestal, NY 13850-2776
Phone: (607) 296-2021
Fax: (607) 296-2023
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X
Mastectomy Fitter Taxonomy 224900000X

Record details

NPI number1316693765
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jamie Walck — Owner · (607) 296-2021
NPI enumeratedFebruary 24, 2022
Last updated in NPPESJuly 26, 2022
Certification dateMay 31, 2022
Mailing address100 Rano Blvd, Vestal, NY 13850-2776

Other providers in Vestal