Provider Demographics
NPI:1336187426
Name:ORTHOPEDICS & SPORTS MEDICINE, PC
Entity type:Organization
Organization Name:ORTHOPEDICS & SPORTS MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-561-8060
Mailing Address - Street 1:219 BLOOMING GROVE TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-7769
Mailing Address - Country:US
Mailing Address - Phone:845-561-8060
Mailing Address - Fax:845-561-8523
Practice Address - Street 1:219 BLOOMING GROVE TPKE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7769
Practice Address - Country:US
Practice Address - Phone:845-561-8060
Practice Address - Fax:845-561-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209883-1207X00000X
NY026213225100000X
NY006544225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0550803000OtherAMERIHEALTH GROUP #
NY0601240OtherGROUP AETNA HMO #
NY01694311Medicaid
NYCD0432OtherGROUP RAILROAD MEDICARE #
NY5121361OtherGROUP AETNA PPO NUMBER
NY01694311Medicaid
NY0550803000OtherAMERIHEALTH GROUP #
NYWKC101Medicare PIN