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General NPI Number Information
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NPI Number | 1588654636
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Entity Type | Organization
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Legal Business Name | UNIVERSITY ORTHOPEDICS OF NEW YORK PLLC
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 2318 31ST ST SUITE 210
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City | ASTORIA
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State | NY
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Zip | 11105-2892
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Country | US
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Telephone | 718-777-1885
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Fax | 718-777-9613
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Provider Business Mailing Address
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Address Line | 2318 31ST ST SUITE 210
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City | ASTORIA
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State | NY
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Zip | 11105-2892
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Country | US
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Telephone | 718-777-1885
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Fax | 718-777-9613
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARTA TECZA
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Credential |
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Telephone | 718-777-1885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 192054
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 192054
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License Number State | NY
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