Healthcare Provider Details

I. General information

NPI: 1801978184
Provider Name (Legal Business Name): MOHAWK VALLEY PLASTIC & RECONSTRUCTIVE SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 MIDDLE SETTLEMENT RD STE 102
NEW HARTFORD NY
13413-5332
US

IV. Provider business mailing address

4401 MIDDLE SETTLEMENT RD STE 102
NEW HARTFORD NY
13413-5332
US

V. Phone/Fax

Practice location:
  • Phone: 315-735-4996
  • Fax: 315-735-7066
Mailing address:
  • Phone: 315-735-4996
  • Fax: 315-735-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number199751
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number199751
License Number StateNY

VIII. Authorized Official

Name: DR. GREG STEVEN ORLANDO
Title or Position: PHYSICIAN
Credential: MD
Phone: 315-266-0407