Provider Demographics
NPI:1033151535
Name:CATSKILL ORANGE ORTHOPAEDICS,PC
Entity Type:Organization
Organization Name:CATSKILL ORANGE ORTHOPAEDICS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WIENER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-692-6224
Mailing Address - Street 1:75 CRYSTAL RUN RD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-7000
Mailing Address - Country:US
Mailing Address - Phone:845-692-6224
Mailing Address - Fax:845-692-4286
Practice Address - Street 1:39 OLD MONTICELLO RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:NY
Practice Address - Zip Code:12734-5224
Practice Address - Country:US
Practice Address - Phone:845-292-4450
Practice Address - Fax:845-292-4642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02709933Medicaid
NYW0J222Medicare PIN
NY02709933Medicaid
NYW0J223Medicare PIN
NY5187480003Medicare NSC
NY5187480001Medicare NSC
NY5187480002Medicare NSC