Healthcare Provider Details

I. General information

NPI: 1093143687
Provider Name (Legal Business Name): HSS NON PAR PROVIDERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

535 E 70TH ST
NEW YORK NY
10021-4823
US

V. Phone/Fax

Practice location:
  • Phone: 646-797-8471
  • Fax:
Mailing address:
  • Phone: 646-797-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number223929
License Number StateNY

VIII. Authorized Official

Name: RICHARD CROWLEY
Title or Position: VICE PRESIDENT
Credential:
Phone: 212-606-1000