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General NPI Number Information
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NPI Number | 1528365525
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Entity Type | Organization
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Legal Business Name | MANHATTAN MEDICAL HIP REPLACEMENT PC
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 530 1ST AVE SUITE 5B
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-7296
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 56TH ST APT 7J
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City | NEW YORK
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State | NY
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Zip | 10022-4136
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Country | US
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Telephone | 212-263-7296
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH F FETTO
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Credential | MD
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Telephone | 212-263-7296
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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 | 124320
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License Number State | NY
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