MEDICARE: NYCONN ORTHOPAEDIC & REHABILITATION SPECIALISTS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447331137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NYCONN ORTHOPAEDIC & REHABILITATION SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	2900 WESTCHESTER AVE
Second Line	:	SUITE 307
City	:	PURCHASE
State	:	NY
Zip	:	10577-2552
Country	:	US
Telephone Number	:	914-249-7000
Fax Number	:	914-249-7034

Provider Business Practice Location Address
First Line	:	1500 ASTOR AVE
Second Line	:	SUITE 1E
City	:	BRONX
State	:	NY
Zip	:	10469-5900
Country	:	US
Telephone Number	:	718-652-0003
Fax Number	:	718-652-0815

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JOHN D. DOWDLE
Credential	:	M.D.
Telephone Number	:	914-249-7000

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	04/10/2008

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