Provider Demographics
NPI:1720169428
Name:NYCONN ORTHOPAEDIC & REHABILITATION SPECIALISTS
Entity type:Organization
Organization Name:NYCONN ORTHOPAEDIC & REHABILITATION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DOWDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-249-7000
Mailing Address - Street 1:2900 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2552
Mailing Address - Country:US
Mailing Address - Phone:914-249-7000
Mailing Address - Fax:914-249-7034
Practice Address - Street 1:657 E MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3423
Practice Address - Country:US
Practice Address - Phone:914-666-5550
Practice Address - Fax:914-241-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCK261Medicare ID - Type Unspecified