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General NPI Number Information
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NPI Number | 1922498757
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Entity Type | Organization
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Legal Business Name | NEW YORK BONE AND JOINT SPECIALISTS OF NJ, LLC
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 528 BOULEVARD
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City | KENILWORTH
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State | NJ
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Zip | 07033-1657
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Country | US
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Telephone | 212-759-4553
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Fax | 212-759-1353
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Provider Business Mailing Address
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Address Line | 528 BOULVARD
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City | KENILWORTH
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State | NJ
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Zip | 07033
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Country | US
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Telephone | 212-759-4453
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Fax | 212-759-1353
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Authorized Official
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Title or Position | MD
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Name | MICHAEL MIZHIRITSKY
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Credential |
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Telephone | 212-759-4553
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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 |
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License Number State |
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