Healthcare Provider Details

I. General information

NPI: 1316116627
Provider Name (Legal Business Name): NYCONN ORTHOPAEDIC & REHABILLITATION SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 MADISON AVE SUITE 201
NEW YORK NY
10016-0701
US

IV. Provider business mailing address

2900 WESTCHESTER AVE SUITE 307
PURCHASE NY
10577-2552
US

V. Phone/Fax

Practice location:
  • Phone: 212-685-1666
  • Fax: 212-865-8612
Mailing address:
  • Phone: 914-249-7000
  • Fax: 914-249-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN D. DOWDLE
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 914-249-7000