Provider Demographics
NPI:1750727632
Name:SEAPORT ORTHOPAEDIC ASSOCIATES
Entity type:Organization
Organization Name:SEAPORT ORTHOPAEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHARE HOLDER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-513-7711
Mailing Address - Street 1:19 BEEKMAN ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1531
Mailing Address - Country:US
Mailing Address - Phone:212-513-7711
Mailing Address - Fax:212-964-4861
Practice Address - Street 1:320 ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3353
Practice Address - Country:US
Practice Address - Phone:845-562-3600
Practice Address - Fax:845-562-3679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEAPORT ORTHOPAEDIC ASSOCIATES,PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty