Healthcare Provider Details

I. General information

NPI: 1033151535
Provider Name (Legal Business Name): CATSKILL ORANGE ORTHOPAEDICS,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 OLD MONTICELLO RD
FERNDALE NY
12734-5224
US

IV. Provider business mailing address

75 CRYSTAL RUN RD SUITE 135
MIDDLETOWN NY
10941-7000
US

V. Phone/Fax

Practice location:
  • Phone: 845-292-4450
  • Fax: 845-292-4642
Mailing address:
  • Phone: 845-692-6224
  • Fax: 845-692-4286

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: BRADLEY D WIENER
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 845-692-6224