Provider Demographics
NPI:1477342483
Name:PROFESSIONAL ORTHOPEDIC SURGERY PLLC
Entity type:Organization
Organization Name:PROFESSIONAL ORTHOPEDIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSIGIORGIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-867-0800
Mailing Address - Street 1:59 CORNWELLS BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1305
Mailing Address - Country:US
Mailing Address - Phone:516-867-0800
Mailing Address - Fax:
Practice Address - Street 1:1000 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4247
Practice Address - Country:US
Practice Address - Phone:516-867-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty