Provider Demographics
NPI:1528423225
Name:UPPER EAST ORTHOPAEDICS, PC
Entity type:Organization
Organization Name:UPPER EAST ORTHOPAEDICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BADILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-986-9200
Mailing Address - Street 1:315 E 83RD ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4301
Mailing Address - Country:US
Mailing Address - Phone:212-986-9200
Mailing Address - Fax:212-986-9400
Practice Address - Street 1:315 E 83RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4301
Practice Address - Country:US
Practice Address - Phone:212-986-9200
Practice Address - Fax:212-986-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty