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General NPI Number Information
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NPI Number | 1881038016
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC ASSOCIATES URGENT CARE
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 04/18/2013
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Provider Practice Location Address
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Address Line | 3333 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-3608
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Country | US
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Telephone | 718-448-3210
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Fax | 718-967-6023
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Provider Business Mailing Address
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Address Line | 2535 ARTHUR KILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1207
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Country | US
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Telephone | 718-448-3210
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Fax | 718-967-6023
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. PAUL BERKLEY
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Credential |
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Telephone | 718-448-3210
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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 | 175801-1
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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 | 210396-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 150987-1
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License Number State | NY
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