Provider Demographics
NPI:1831196757
Name:EXCELSIOR ORTHOPAEDICS LLP
Entity type:Organization
Organization Name:EXCELSIOR ORTHOPAEDICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-250-6409
Mailing Address - Street 1:3925 SHERIDAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1738
Mailing Address - Country:US
Mailing Address - Phone:716-250-9999
Mailing Address - Fax:716-250-6555
Practice Address - Street 1:3925 SHERIDAN DRIVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1738
Practice Address - Country:US
Practice Address - Phone:716-250-9999
Practice Address - Fax:716-250-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1232Medicare PIN
NY5216910002Medicare NSC