Organization
ADVANCED ORTHOPEDICS & SPORTS MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELENE KRAUSHAAR (ADMINISTRATOR)
(845) 425-0555
Entity
Organization
Contact information
Practice address
408 AIRPORT EXECUTIVE PARK, NANUET, NY 10954-5288
(845) 425-0555
(845) 426-6126
Mailing address
408 AIRPORT EXECUTIVE PARK, NANUET, NY 10954-5288
(845) 425-0555
(845) 426-6126
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0599457
GHI-FLEX SELECT
NY
01
—
2195612
AETNA/ USHC HMO
NY
01
—
7864033
AETNA /USHC-PPO/POS
NY
Enumeration date
09/20/2006
Last updated
06/23/2016
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