Organization
SUFFOLK ORTHOPAEDIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J TABERSHAW MD (PRESIDENT)
(631) 665-8790
Entity
Organization
Contact information
Practice address
375 E MAIN ST, STE 1, BAY SHORE, NY 11706-8418
(631) 665-8790
(631) 665-1581
Mailing address
375 E MAIN ST, STE 1, BAY SHORE, NY 11706-8418
(631) 665-8790
(631) 665-1581
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
12/20/2007
Last updated
09/17/2013
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