1750412706 NPI number — NEW YORK ORTHOPEDIC SPECIALISTS PC

Table of content: (NPI 1750412706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750412706 NPI number — NEW YORK ORTHOPEDIC SPECIALISTS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK ORTHOPEDIC SPECIALISTS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750412706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 DEER PARK MEADOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWICH
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06830-3804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-629-3428
Provider Business Mailing Address Fax Number:
914-725-3291

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 WHITE PLAINS RD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
SCARSDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-723-4244
Provider Business Practice Location Address Fax Number:
914-725-3291
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAIG
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
VANDERWINK
Authorized Official Title or Position:
MD OWNER
Authorized Official Telephone Number:
914-723-4244

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  168044 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: WWR891 . This is a "MEDICARE ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com