Organization
ATLAS ORTHOSURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MCCULLOCH MD (PRESIDENT)
12125881919
Entity
Organization
Contact information
Practice address
333 E 56TH ST, NEW YORK, NY 10022-3758
(212) 588-1919
Mailing address
11616 QUEENS BLVD, SUITE 222, FOREST HILLS, NY 11375-7012
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/29/2012
Last updated
01/29/2012
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