Organization
ADVANCED ORTHOPEDICS AND JOINT PRESERVATION PC
Active
Organization
ADVANCED ORTHOPEDICS AND JOINT PRESERVATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANISLAV AVSHALUMOV D.O., M.D. (PRESIDENT)
(516) 887-5500
Entity
Organization
Contact information
Practice address
141 E MERRICK RD, SUITE B, VALLEY STREAM, NY 11580-5925
(516) 887-5500
(516) 887-5509
Mailing address
141 E MERRICK RD, SUITE B, VALLEY STREAM, NY 11580-5925
(516) 887-5500
(516) 887-5509
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
233630
NY
207XP3100X
Pediatric Orthopaedic Surgery Physician
233630
NY
207XS0106X
Orthopaedic Hand Surgery Physician
233630
NY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
233630
NY
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
233630
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
233630
NY
207XX0801X
Orthopaedic Trauma Physician
233630
NY
Other
Enumeration date
09/21/2012
Last updated
09/03/2015
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