Provider Demographics
NPI:1063668911
Name:NASSAU ORTHOPEDIC SURGEONS
Entity Type:Organization
Organization Name:NASSAU ORTHOPEDIC SURGEONS
Other - Org Name:PERFORMANCE SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DOERBECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-735-7778
Mailing Address - Street 1:2920 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1402
Mailing Address - Country:US
Mailing Address - Phone:516-735-7778
Mailing Address - Fax:516-735-4159
Practice Address - Street 1:2920 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1402
Practice Address - Country:US
Practice Address - Phone:516-735-7778
Practice Address - Fax:516-735-4159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty