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General NPI Number Information
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NPI Number | 1144557596
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPEDIC SURGERY AND SPORTS MEDICINE, PLLC
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | 1800 WALT WHITMAN RD
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City | MELVILLE
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State | NY
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Zip | 11747-3099
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Country | US
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Telephone | 631-231-0300
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Fax | 631-231-3331
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Provider Business Mailing Address
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Address Line | 1800 WALT WHITMAN RD SUITE 120
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City | MELVILLE
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State | NY
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Zip | 11747-3099
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Country | US
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Telephone | 631-231-0300
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Fax | 631-231-3331
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Authorized Official
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Title or Position | MD
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Name | DR. ERIC A PUTTERMAN
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Credential | MD
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Telephone | 631-231-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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