Healthcare Provider Details

I. General information

NPI: 1942567102
Provider Name (Legal Business Name): RYC ORTHOPAEDICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 E 86TH ST # 1A
NEW YORK NY
10028-1059
US

IV. Provider business mailing address

PO BOX 941
ITHACA NY
14851-0941
US

V. Phone/Fax

Practice location:
  • Phone: 212-427-7750
  • Fax: 212-427-7759
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number219451
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number147983
License Number StateNY

VIII. Authorized Official

Name: DONALD ROSE
Title or Position: OWNER
Credential:
Phone: 212-348-3636