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General NPI Number Information
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NPI Number | 1679753875
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC SURGICAL SPECIALIST & REHABILITATION PLLC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 90 PRINCE ST
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City | KINGSTON
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State | NY
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Zip | 12401-4635
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Country | US
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Telephone | 845-339-6637
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Fax | 845-339-1197
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Provider Business Mailing Address
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Address Line | 90 PRINCE ST
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City | KINGSTON
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State | NY
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Zip | 12401-4635
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Country | US
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Telephone | 845-339-6637
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Fax | 845-339-1197
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ADAM D SOYER
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Credential | D.O.
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Telephone | 845-339-6637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 205109
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License Number State | NY
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