Healthcare Provider Details

I. General information

NPI: 1770117483
Provider Name (Legal Business Name): THE CENTRAL ORTHOPEDIC GROUP L L P
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 MERRICK RD
MASSAPEQUA NY
11758-6225
US

IV. Provider business mailing address

5840 MERRICK RD
MASSAPEQUA NY
11758-6225
US

V. Phone/Fax

Practice location:
  • Phone: 516-681-8822
  • Fax:
Mailing address:
  • Phone: 516-681-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SCOTT SILVERBERG
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 516-681-8822