Healthcare Provider Details

I. General information

NPI: 1851482905
Provider Name (Legal Business Name): NEW YORK ORTHOPEDIC AND SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 NORTHERN BLVD SUITE 220
GREAT NECK NY
11021-5308
US

IV. Provider business mailing address

PO BOX 222076
GREAT NECK NY
11022-2076
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-7900
  • Fax: 516-498-9385
Mailing address:
  • Phone: 516-622-7900
  • Fax: 516-498-9385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: EUGENE S KRAUSS
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 516-622-7990