Provider Demographics
NPI:1306876008
Name:ORANGE SURGICAL GROUP
Entity type:Organization
Organization Name:ORANGE SURGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KULAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-692-3111
Mailing Address - Street 1:236 CRYSTAL RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4009
Mailing Address - Country:US
Mailing Address - Phone:845-692-3111
Mailing Address - Fax:845-692-0125
Practice Address - Street 1:236 CRYSTAL RUN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4009
Practice Address - Country:US
Practice Address - Phone:845-692-3111
Practice Address - Fax:845-692-0125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty