Basic Information
| Provider Information | |||||||||
| NPI: | 1437455847 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOMERS ORTHOPAEDIC SURGERY AND SPORTS MEDICINE GROUP PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 664 STONELEIGH AVE | ||||||||
| Address2: | STE. 300 | ||||||||
| City: | CARMEL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105123940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452272228 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 WESTAGE BUSINESS CTR DR | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | FISHKILL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125242223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8452272228 | ||||||||
| FaxNumber: | 8452272229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2011 | ||||||||
| LastUpdateDate: | 07/30/2015 | ||||||||
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| AuthorizedOfficialLastName: | BUCHALTER | ||||||||
| AuthorizedOfficialFirstName: | JOEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8452788400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.