Provider Demographics
NPI:1003215484
Name:424 ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:424 ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:I
Authorized Official - Last Name:SPRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-813-2543
Mailing Address - Street 1:424 MADISON AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1164
Mailing Address - Country:US
Mailing Address - Phone:212-813-2543
Mailing Address - Fax:212-813-2519
Practice Address - Street 1:424 MADISON AVE FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1164
Practice Address - Country:US
Practice Address - Phone:212-813-2543
Practice Address - Fax:212-813-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108983174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB16710Medicare UPIN