Provider Demographics
NPI:1851482905
Name:NEW YORK ORTHOPEDIC AND SPINE
Entity Type:Organization
Organization Name:NEW YORK ORTHOPEDIC AND SPINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-622-7990
Mailing Address - Street 1:PO BOX 222076
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11022-2076
Mailing Address - Country:US
Mailing Address - Phone:516-622-7900
Mailing Address - Fax:516-498-9385
Practice Address - Street 1:833 NORTHERN BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5308
Practice Address - Country:US
Practice Address - Phone:516-622-7900
Practice Address - Fax:516-498-9385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W30651Medicare ID - Type Unspecified