Provider Demographics
NPI:1760775308
Name:SPORTS INJURIES & ARTHRITIS SURGERY, PC
Entity Type:Organization
Organization Name:SPORTS INJURIES & ARTHRITIS SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:FLEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-988-9400
Mailing Address - Street 1:942 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2656
Mailing Address - Country:US
Mailing Address - Phone:212-988-9400
Mailing Address - Fax:212-249-5463
Practice Address - Street 1:942 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2656
Practice Address - Country:US
Practice Address - Phone:212-988-9400
Practice Address - Fax:212-249-5463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127297207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty