Basic Information
| Provider Information | |||||||||
| NPI: | 1184284580 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL NEW YORK ORTHOPEDICS LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 MIDDLE SETTLEMENT RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | NEW HARTFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134135332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157354496 | ||||||||
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| Address1: | 4401 MIDDLE SETTLEMENT RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | NEW HARTFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 134135332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3157354496 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2019 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| AuthorizedOfficialLastName: | WICKLINE | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD | ||||||||
| AuthorizedOfficialTelephone: | 3157354496 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.