Basic Information
| Provider Information | |||||||||
| NPI: | 1588107015 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPEDICSNY, LLP | ||||||||
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| OtherOrganizationName: | ORTHONY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 EVERETT RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122051474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184539088 | ||||||||
| FaxNumber: | 5186893896 | ||||||||
| Practice Location | |||||||||
| Address1: | 1760 UNION ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185572228 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2016 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| AuthorizedOfficialLastName: | GERRY | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5184539088 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ORTHOPEDICSNY, LLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.