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General NPI Number Information
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NPI Number | 1346544194
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Entity Type | Organization
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Legal Business Name | BARTON NISONSON, M.D. PC
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 130 EAST 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1851
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Country | US
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Telephone | 212-570-9120
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Fax | 212-717-4876
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Provider Business Mailing Address
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Address Line | 130 EAST 77TH ST
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City | NEW YORK CITY
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State | NY
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Zip | 10075-1851
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Country | US
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Telephone | 212-570-9120
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Fax | 212-717-4876
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Authorized Official
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Title or Position | PHYSICIAN'S ASSISTANT/OFFICE MANAGE
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Name | MS. ROSEMARIE MAZZA
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Credential | OPA-C
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Telephone | 212-570-9120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 099856
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 099856
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 099856
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License Number State | NY
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