Healthcare Provider Details

I. General information

NPI: 1235075656
Provider Name (Legal Business Name): TRUE NORTH MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 QUEENS BLVD STE 602
REGO PARK NY
11374-4503
US

IV. Provider business mailing address

9525 QUEENS BLVD STE 602
REGO PARK NY
11374-4503
US

V. Phone/Fax

Practice location:
  • Phone: 212-400-6633
  • Fax: 212-260-5260
Mailing address:
  • Phone: 212-400-6633
  • Fax: 212-260-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SHARLENE BRONSTORPH
Title or Position: DIRECTOR
Credential:
Phone: 516-850-3999