Healthcare Provider Details

I. General information

NPI: 1982933164
Provider Name (Legal Business Name): CONTEMPORARY ORTHOPEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2009
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 NOSTRAND AVE
BROOKLYN NY
11229-5107
US

IV. Provider business mailing address

3041 AVENUE U STE 3
BROOKLYN NY
11229-5143
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-0909
  • Fax:
Mailing address:
  • Phone: 718-338-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE R MEDINA
Title or Position: MEDICAL SURGICAL BILLING
Credential:
Phone: 718-338-0909