Provider Demographics
NPI:1982004529
Name:NY SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING
Entity Type:Organization
Organization Name:NY SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING
Other - Org Name:HSS ORTHO 1
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-606-1224
Mailing Address - Street 1:PO BOX 29234
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9234
Mailing Address - Country:US
Mailing Address - Phone:212-774-7598
Mailing Address - Fax:646-714-6489
Practice Address - Street 1:140 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE 175S
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3917
Practice Address - Country:US
Practice Address - Phone:212-774-7598
Practice Address - Fax:646-714-6489
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK SOCIETY FOR THE RELIEF OF THE RUPTURED & CRIPPLED MAINTAINING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-02
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty