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General NPI Number Information
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NPI Number | 1285223248
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Entity Type | Organization
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Legal Business Name | SOUTH ISLAND ORTHOPEDICS, P.C.
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/22/2021
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Provider Practice Location Address
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Address Line | 205 FROEHLICH FARM BLVD
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City | WOODBURY
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State | NY
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Zip | 11797-2931
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Country | US
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Telephone | 516-364-0070
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Fax | 978-313-8511
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Provider Business Mailing Address
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Address Line | 657 CENTRAL AVE
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City | CEDARHURST
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State | NY
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Zip | 11516-2320
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Country | US
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Telephone | 516-295-0111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIC L FREEMAN
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Credential | MD
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Telephone | 516-295-0111
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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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