Provider Demographics
NPI:1922092717
Name:ORTHOPAEDIC ASSOCIATES OF MANHASSET PC
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF MANHASSET PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEIDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-8717
Mailing Address - Street 1:600 NORTHERN BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5200
Mailing Address - Country:US
Mailing Address - Phone:516-627-8717
Mailing Address - Fax:516-365-1634
Practice Address - Street 1:600 NORTHERN BLVD
Practice Address - Street 2:STE 300
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5200
Practice Address - Country:US
Practice Address - Phone:516-627-8717
Practice Address - Fax:516-570-4037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCF1039OtherMEDICARE ID
NYWES691Medicare PIN
NYCF1039OtherMEDICARE ID