Healthcare Provider Details

I. General information

NPI: 1356797435
Provider Name (Legal Business Name): BRIAN JOSEPH PAGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2016
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E 70TH ST
NEW YORK NY
10021-9800
US

IV. Provider business mailing address

PO BOX 29234
NEW YORK NY
10087-9234
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-3128
  • Fax: 646-719-2246
Mailing address:
  • Phone: 646-962-3128
  • Fax: 203-391-2277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number308627
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberR9118
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberBP10057654
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: