Healthcare Provider Details

I. General information

NPI: 1386972073
Provider Name (Legal Business Name): ORTHONET NEW YORK IPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2009
Last Update Date: 11/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 MAMARONECK AVE STE 240
WHITE PLAINS NY
10605-5222
US

IV. Provider business mailing address

1311 MAMARONECK AVE STE 240
WHITE PLAINS NY
10605-5222
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-8800
  • Fax: 914-681-8899
Mailing address:
  • Phone: 914-681-8800
  • Fax: 914-681-8899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL H. SINGER
Title or Position: SECRETARY, EXECUTIVE VICE PRESIDENT
Credential:
Phone: 914-681-8800