1689775280 NPI number — ORTHOPAEDIC ASSOCIATES LLP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689775280 NPI number — ORTHOPAEDIC ASSOCIATES LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC ASSOCIATES LLP
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:
ORTHOPAEDIC ASSOCIATES OF CENTRAL OF NEW YORK
Provider Other Organization Name Type Code:
3
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:
1689775280
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 IRVING AVE
Provider Second Line Business Mailing Address:
SUITE 418
Provider Business Mailing Address City Name:
SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-426-0190
Provider Business Mailing Address Fax Number:
315-426-9192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
475 IRVING AVE
Provider Second Line Business Practice Location Address:
SUITE 418
Provider Business Practice Location Address City Name:
SYRACUSE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-426-0190
Provider Business Practice Location Address Fax Number:
315-426-9192
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARRETT
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ADMINSITRATOR
Authorized Official Telephone Number:
315-426-0190

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2081P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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