Healthcare Provider Details

I. General information

NPI: 1316520125
Provider Name (Legal Business Name): NEW YORK HAND SURGERY OF QUEENS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5407 ROOSEVELT AVE
WOODSIDE NY
11377-4240
US

IV. Provider business mailing address

5407 ROOSEVELT AVE
WOODSIDE NY
11377-4240
US

V. Phone/Fax

Practice location:
  • Phone: 718-369-4263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: VIPUL PATEL
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 718-369-4263