Provider Demographics
NPI:1992976922
Name:ORTHOPEDIC SPECIALISTS OF NEW YORK
Entity type:Organization
Organization Name:ORTHOPEDIC SPECIALISTS OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STRUAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-676-5014
Mailing Address - Street 1:150 FOREST AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2019
Mailing Address - Country:US
Mailing Address - Phone:516-676-5014
Mailing Address - Fax:
Practice Address - Street 1:150 FOREST AVE STE 150
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2019
Practice Address - Country:US
Practice Address - Phone:516-676-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205855207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH74142Medicare UPIN
NYB78102Medicare UPIN