Provider Demographics
NPI:1346507738
Name:ORTHO URGENT CARE
Entity Type:Organization
Organization Name:ORTHO URGENT CARE
Other - Org Name:SPINAL & SKELETAL PAIN MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ZAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-798-8737
Mailing Address - Street 1:1508 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5178
Mailing Address - Country:US
Mailing Address - Phone:315-798-8737
Mailing Address - Fax:315-797-6346
Practice Address - Street 1:502 W BROAD ST
Practice Address - Street 2:COMMERCIAL SUITE 200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3204
Practice Address - Country:US
Practice Address - Phone:703-894-2228
Practice Address - Fax:703-997-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty