Healthcare Provider Details

I. General information

NPI: 1851406961
Provider Name (Legal Business Name): TWIN TIER ORTHOPEDIC & HAND SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 OLD VESTAL ROAD
VESTAL NY
13850
US

IV. Provider business mailing address

4500 OLD VESTAL ROAD
VESTAL NY
13850
US

V. Phone/Fax

Practice location:
  • Phone: 607-729-6226
  • Fax: 607-729-6227
Mailing address:
  • Phone: 607-729-6226
  • Fax: 607-729-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number1007951
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number1007951
License Number StateNY

VIII. Authorized Official

Name: FAROUQ AL-KHALIDI
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 607-729-6226