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Organization
SPORTS & ORTHOPEDIC SURGERY OF NEW YORK, PLLC
Active
Organization
SPORTS & ORTHOPEDIC SURGERY OF NEW YORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN J FERNANDEZ-MADRID M.D. (SOLE PROPRIETOR)
(212) 254-0946
Entity
Organization
Contact information
Practice address
205 E 16TH ST, SUITE M1B, NEW YORK, NY 10003-3746
(212) 254-0946
(212) 254-0956
Mailing address
PO BOX 6402, ITHACA, NY 14851-6402
(212) 254-0946
(212) 254-0956
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
217407
NY
Other
Enumeration date
06/29/2007
Last updated
03/07/2011
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