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General NPI Number Information
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NPI Number | 1023705803
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Entity Type | Organization
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Legal Business Name | NEW YORK SOCIETY FOR THE RELIEF OF RUPTURED & CRIPPLED MAINTAINING
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Dates
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Enumeration Date | 04/20/2023
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 56 FLYING POINT RD
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5352
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Country | US
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Telephone | 646-714-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 535 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4823
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Country | US
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Telephone | 646-714-6353
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Fax |
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Authorized Official
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Title or Position | ASSISTANT VICE PRESIDENT
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Name | JOSHUA MILLER
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Credential |
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Telephone | 646-714-6353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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