Provider Demographics
NPI:1821499765
Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED
Entity Type:Organization
Organization Name:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED AND CRIPPLED
Other - Org Name:HSS ORTHOPEDICS 2 ARM NJ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF PHYSICIAN SERVICE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-606-1224
Mailing Address - Street 1:140 E RIDGEWOOD AVE
Mailing Address - Street 2:175 SOUTH
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3917
Mailing Address - Country:US
Mailing Address - Phone:212-774-7598
Mailing Address - Fax:
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:ATTENTION: CATHERINE LEE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4823
Practice Address - Country:US
Practice Address - Phone:212-774-7598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY700201211207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty