Provider Demographics
NPI:1649396433
Name:SCOLIOSIS AND SPINE SURGERY, P.C,
Entity Type:Organization
Organization Name:SCOLIOSIS AND SPINE SURGERY, P.C,
Other - Org Name:RUDOLPH F.TADDONIO, MD, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ACCOUNTS SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOTAROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-288-0045
Mailing Address - Street 1:244 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 316
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2907
Mailing Address - Country:US
Mailing Address - Phone:914-288-0045
Mailing Address - Fax:914-288-0065
Practice Address - Street 1:244 WESTCHESTER AVE
Practice Address - Street 2:SUITE 316
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-2907
Practice Address - Country:US
Practice Address - Phone:914-288-0045
Practice Address - Fax:914-288-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032861207XS0117X
NY112892207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEQ201Medicare PIN
CTC03469Medicare PIN