=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083347157
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RYC ORTHOPAEDICS, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2022
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 E 86TH ST # 1A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10028-1059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-348-3636
-----------------------------------------------------
Fax | 212-410-3338
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 E 86TH ST # 1A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10028-1059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-348-3636
-----------------------------------------------------
Fax | 212-410-3338
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DONALD ROSE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 212-348-3636
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------