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NPI Code Detail

MEDICARE: ADVANCE ORTHOPEDIC AND SPINE CARE, PLLC

MEDICARE: ADVANCE ORTHOPEDIC AND SPINE CARE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204D00000XNeuromusculoskeletal Medicine & OMM Physician238138NY
2207X00000XOrthopaedic Surgery Physician238138NY
3207XS0117XOrthopaedic Surgery of the Spine Physician238138NY

General Provider Information

NPI Number : 1508895657
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCE ORTHOPEDIC AND SPINE CARE, PLLC
Provider Business Mailing Address
First Line : 3059 BRIGHTON 13TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5607
Country : US
Telephone Number : 718-891-7100
Fax Number : 718-891-3834
Provider Business Practice Location Address
First Line : 3059 BRIGHTON 13TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-5607
Country : US
Telephone Number : 718-891-7100
Fax Number : 718-891-3834
Authorized Official
Title or Position : OWNER
Name : DR. KAREN AVANESOV
Credential : D.O
Telephone Number : 718-891-7100
Provider Enumeration Date : 07/01/2006
Last Update Date : 11/25/2013

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Directions to “ADVANCE ORTHOPEDIC AND SPINE CARE, PLLC ” Practice Location

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