Provider Demographics
NPI:1306045117
Name:ORTHOPEDIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-283-6430
Mailing Address - Street 1:1660 E 14TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1170
Mailing Address - Country:US
Mailing Address - Phone:718-375-0011
Mailing Address - Fax:718-375-3305
Practice Address - Street 1:1660 E 14TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1170
Practice Address - Country:US
Practice Address - Phone:718-375-0011
Practice Address - Fax:718-375-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127247174400000X
NY139549174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A64695Medicare UPIN
A62136Medicare UPIN
90A021Medicare Oscar/Certification
319751Medicare UPIN
319751Medicare PIN
A64695Medicare Oscar/Certification
A62136Medicare Oscar/Certification
A64695Medicare PIN
90A021Medicare UPIN
319751Medicare Oscar/Certification
A62136Medicare PIN
90A021Medicare PIN