Healthcare Provider Details

I. General information

NPI: 1881693398
Provider Name (Legal Business Name): ARTHRITIS AND OSTEOPOROSIS MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 JORALEMON ST 8TH FLOOR
BROOKLYN NY
11201-4326
US

IV. Provider business mailing address

186 JORALEMON ST 8TH FLOOR
BROOKLYN NY
11201-4326
US

V. Phone/Fax

Practice location:
  • Phone: 718-858-3263
  • Fax: 718-858-5095
Mailing address:
  • Phone: 718-858-3263
  • Fax: 718-858-5095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNY

VIII. Authorized Official

Name: DAVID H GODDARD
Title or Position: PARTNER
Credential: MD
Phone: 718-858-3263