Healthcare Provider Details

I. General information

NPI: 1588107015
Provider Name (Legal Business Name): ORTHOPEDICSNY, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2016
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 UNION ST SUITE 100
SCHENECTADY NY
12309
US

IV. Provider business mailing address

121 EVERETT RD SUITE 100
ALBANY NY
12205-1474
US

V. Phone/Fax

Practice location:
  • Phone: 518-557-2228
  • Fax:
Mailing address:
  • Phone: 518-453-9088
  • Fax: 518-689-3896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DIANE GERRY
Title or Position: DIRECTOR
Credential:
Phone: 518-453-9088