Provider Demographics
NPI:1316209299
Name:ORTHOPEDICSNY, LLP
Entity Type:Organization
Organization Name:ORTHOPEDICSNY, LLP
Other - Org Name:ORTHONY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-453-9088
Mailing Address - Street 1:121 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1447
Mailing Address - Country:US
Mailing Address - Phone:518-453-9088
Mailing Address - Fax:518-689-3896
Practice Address - Street 1:2 EMPIRE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144
Practice Address - Country:US
Practice Address - Phone:518-286-9032
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDICSNY, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-15
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55720AMedicare PIN