Provider Demographics
NPI:1083661763
Name:HAND SURGERY ASSOCIATES OF LI, PC
Entity Type:Organization
Organization Name:HAND SURGERY ASSOCIATES OF LI, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-427-4263
Mailing Address - Street 1:166 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2948
Mailing Address - Country:US
Mailing Address - Phone:631-427-4263
Mailing Address - Fax:631-427-4279
Practice Address - Street 1:166 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2948
Practice Address - Country:US
Practice Address - Phone:631-427-4263
Practice Address - Fax:631-427-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1017400001Medicare NSC
WANR11Medicare PIN