Healthcare Provider Details

I. General information

NPI: 1225119894
Provider Name (Legal Business Name): NYCONN ORTHOPAEDIC & REHABILITATION SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WESTAGE BUSINESS CTR DR SUITE 314
FISHKILL NY
12524-2264
US

IV. Provider business mailing address

2900 WESTCHESTER AVE SUITE 307
PURCHASE NY
10577-2552
US

V. Phone/Fax

Practice location:
  • Phone: 845-838-8152
  • Fax: 845-279-3490
Mailing address:
  • Phone: 914-249-7000
  • Fax: 914-249-7034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JOHN D. DOWDLE
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 914-249-7000