Provider Demographics
NPI:1588085757
Name:GOTHAM CITY SPORTS MEDICINE, PLLC
Entity type:Organization
Organization Name:GOTHAM CITY SPORTS MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-928-1325
Mailing Address - Street 1:50 MT. PROSPECT AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-928-1325
Mailing Address - Fax:
Practice Address - Street 1:20 E 46TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2417
Practice Address - Country:US
Practice Address - Phone:973-928-1325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241118-1207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty