Provider Demographics
NPI:1760761340
Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINI
Entity Type:Organization
Organization Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINI
Other - Org Name:HSS SPINE AND SPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-606-1625
Mailing Address - Street 1:600 HERITAGE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3000
Mailing Address - Country:US
Mailing Address - Phone:561-253-8737
Mailing Address - Fax:
Practice Address - Street 1:600 HERITAGE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3000
Practice Address - Country:US
Practice Address - Phone:561-253-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED MAINTAINI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-08-12
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7002012H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital