Organization
NEW YORK SPINE SURGERY & REHABILITATION MEDICINE, PLLC
Active
Organization
NEW YORK SPINE SURGERY & REHABILITATION MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE ELAINE REEDER (OFFICE MANAGER)
(845) 471-9200
Entity
Organization
Contact information
Practice address
243 NORTH RD, SUITE 202S, POUGHKEEPSIE, NY 12601-1172
(845) 471-9200
(845) 471-1551
Mailing address
243 NORTH RD, SUITE 202S, POUGHKEEPSIE, NY 12601-1172
(845) 471-9200
(845) 471-1551
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
202111-0
NY
208100000X
Physical Medicine & Rehabilitation Physician
225259-1
NY
363AM0700X
Medical Physician Assistant
011524-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R000
CDPHP
NY
Enumeration date
02/01/2007
Last updated
02/19/2008
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