Organization
ORTHOPAEDICS NORTHEAST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND KUSISTO (CEO)
(260) 484-8551
Entity
Organization
Contact information
Practice address
8202 GLENCARIN BLVD STE 300, FORT WAYNE, IN 46804-5783
(260) 484-8551
(260) 484-9603
Mailing address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 484-9603
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/24/2006
Last updated
03/27/2025
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