Provider Demographics
NPI:1508204520
Name:ORBASH, AMY REYNE (SPECIALIST ASSISTANT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:REYNE
Last Name:ORBASH
Suffix:
Gender:F
Credentials:SPECIALIST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:227 MADISON ST
Mailing Address - Street 2:MEDICAL STAFF AFFAIRS, ROOM 1249
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7537
Mailing Address - Country:US
Mailing Address - Phone:212-238-7614
Mailing Address - Fax:212-238-7009
Practice Address - Street 1:227 MADISON ST
Practice Address - Street 2:MEDICAL STAFF AFFAIRS, ROOM 1249
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7537
Practice Address - Country:US
Practice Address - Phone:212-238-7614
Practice Address - Fax:212-238-7009
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000197243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000197OtherNYS RADIOLOGIST SPECIALIST ASSISTANT