Organization
MCCULLOCH ORTHOPAEDIC SURGICAL SERVICES, PLLC
Active
Other names
NY Sports and Joints
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MCCULLOCH (COO)
(734) 645-3899
Entity
Organization
Contact information
Practice address
12510 QUEENS BLVD STE 9, KEW GARDENS, NY 11415-1522
(212) 355-5555
(877) 992-0798
Mailing address
520 FRANKLIN AVE STE 212, GARDEN CITY, NY 11530-5815
(212) 355-5555
(877) 992-0798
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02880678
—
NY
05
—
02880679
—
NY
Enumeration date
05/18/2010
Last updated
02/04/2026
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