Provider Demographics
NPI:1144392085
Name:HOSTIN ORTHOPAEDICS & SPORTS MEDICINE, PC
Entity Type:Organization
Organization Name:HOSTIN ORTHOPAEDICS & SPORTS MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-249-4240
Mailing Address - Street 1:3801 PURCHASE ST
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-1119
Mailing Address - Country:US
Mailing Address - Phone:212-249-4240
Mailing Address - Fax:855-693-7089
Practice Address - Street 1:369 LEXINGTON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6536
Practice Address - Country:US
Practice Address - Phone:212-249-4240
Practice Address - Fax:855-693-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225878174400000X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH76627Medicare UPIN