MEDICARE: CENTER FOR ORTHOPAEDIC SURGERY, LLP

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
1	207XS0106X	Orthopaedic Hand Surgery Physician	209052	NY
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	209052	NY
3	207X00000X	Orthopaedic Surgery Physician	209052	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02652	OTHER	NY	MEDICARE ID TYPE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740319607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR ORTHOPAEDIC SURGERY, LLP

Provider Business Mailing Address
First Line	:	3612 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2039
Country	:	US
Telephone Number	:	718-409-9494
Fax Number	:	718-824-8026

Provider Business Practice Location Address
First Line	:	3612 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-2039
Country	:	US
Telephone Number	:	718-409-9494
Fax Number	:	718-824-8026

Authorized Official
Title or Position	:	OWNER
Name	:	DR. EIAL FAIERMAN
Credential	:	MD
Telephone Number	:	718-409-9494

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	04/23/2009

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Directions to “CENTER FOR ORTHOPAEDIC SURGERY, LLP ” Practice Location

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