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General NPI Number Information
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NPI Number | 1457524084
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Entity Type | Organization
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Legal Business Name | ORRIS MD PLLC
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Dates
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Enumeration Date | 04/03/2008
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 1192 BROADWAY
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City | BROOKLYN
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State | NY
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Zip | 11221-3018
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Country | US
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Telephone | 718-963-2300
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Fax | 718-963-2364
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Provider Business Mailing Address
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Address Line | 415 CENTRAL PARK W 6D
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City | NEW YORK
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State | NY
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Zip | 10025-4856
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Country | US
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Telephone | 917-692-9070
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETER
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Name | MAXINE ORRIS
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Credential |
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Telephone | 718-963-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 222807
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License Number State | NY
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