Organization
ACTIVE ORTHOPAEDICS & SPORTS MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS ROBERT HARDING M.D. (DIRECTOR)
(631) 694-0000
Entity
Organization
Contact information
Practice address
340 BROADHOLLOW RD, FARMINGDALE, NY 11735-4807
(631) 694-0000
Mailing address
340 BROADHOLLOW RD, FARMINGDALE, NY 11735-4807
(631) 694-0000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WWT461
GROUP
—
Enumeration date
11/21/2006
Last updated
09/26/2007
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