Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Northeast Orthopedics and Sports Medicine PLLC

Organization Orthopaedic Surgery Physician · NPI 1073937579

Northeast Orthopedics and Sports Medicine PLLC is an Orthopaedic Surgery Physician in Nanuet, New York. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

507 Airport Executive Park
Nanuet, NY 10954-5238
Phone: (845) 262-5313
Fax: (845) 262-5330
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X
Orthopaedic Surgery Physician Taxonomy 207X00000X

Record details

NPI number1073937579
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jordan Simon — Mbr · (845) 262-5313
NPI enumeratedFebruary 5, 2014
Last updated in NPPESDecember 16, 2016
Mailing address507 Airport Executive Park, Nanuet, NY 10954-5238

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