Provider Demographics
NPI:1568415412
Name:ORTHOPEDICSNY, LLP
Entity Type:Organization
Organization Name:ORTHOPEDICSNY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR , PT FINANCIAL SERVS
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERRY
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CPMA
Authorized Official - Phone:518-453-9088
Mailing Address - Street 1:121 EVERETT ROAD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205
Mailing Address - Country:US
Mailing Address - Phone:518-453-9088
Mailing Address - Fax:518-689-3895
Practice Address - Street 1:121 EVERETT ROAD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-453-9088
Practice Address - Fax:518-689-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55720AMedicare PIN
NY1069000001Medicare NSC