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General NPI Number Information
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NPI Number | 1487091583
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Entity Type | Organization
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Legal Business Name | GUNDEL ORTHOPEDICS, PLLC
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Dates
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Enumeration Date | 05/29/2013
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Last Update Date | 05/29/2013
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Provider Practice Location Address
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Address Line | 2 MOUNTAIN LEDGE STE 3
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City | WILTON
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State | NY
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Zip | 12831-2539
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Country | US
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Telephone | 518-484-1656
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Fax | 518-584-1822
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Provider Business Mailing Address
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Address Line | 2 MOUNTAIN LEDGE STE 3
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City | WILTON
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State | NY
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Zip | 12831-2539
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Country | US
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Telephone | 518-484-1656
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Fax | 518-584-1822
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY GUNDEL
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Credential | MD
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Telephone | 518-584-1656
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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 | 201261
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License Number State | NY
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