New York Spine Surgery & Rehabilitation Medicine, PLLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

202111-0 Issued in NY

Legal business name

NEW YORK SPINE SURGERY & REHABILITATION MEDICINE, PLLC

Practice address

243 North Rd
Suite 202S
Poughkeepsie, NY 12601-1172

Phone

(845) 471-9200

Fax

(845) 471-1551

NPI assigned

Feb 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jacqueline Elaine Reeder

Title

Office Manager

Phone

(845) 471-9200

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1295872679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "SUITE 202S",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011172",
            "telephone_number": "845-471-9200",
            "fax_number": "845-471-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 NORTH RD",
            "address_2": "SUITE 202S",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011172",
            "telephone_number": "845-471-9200",
            "fax_number": "845-471-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK SPINE SURGERY & REHABILITATION MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "REEDER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "845-471-9200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "202111-0",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "225259-1",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "011524-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "R000",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.