1174776744 NPI number — ORTHOPEDIC & SPORTS PHYSICAL THERAPY ASSOCIATES, INC.

Table of content: MRS. PRECY LAVINA DSOUZA RN,PCCN,MSN (NPI 1790351872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174776744 NPI number — ORTHOPEDIC & SPORTS PHYSICAL THERAPY ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC & SPORTS PHYSICAL THERAPY ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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Provider Other Name Suffix Text:
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NPI Number Information

NPI Number:
1174776744
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54A LEBANON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIONTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15401-4127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-439-6294
Provider Business Mailing Address Fax Number:
724-439-8941

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54A LEBANON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-4127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-439-6294
Provider Business Practice Location Address Fax Number:
724-439-8941
Provider Enumeration Date:
10/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HENSON
Authorized Official First Name:
JODY
Authorized Official Middle Name:
Authorized Official Title or Position:
PT
Authorized Official Telephone Number:
724-483-3361

Provider Taxonomy Codes

  • Taxonomy code: 332BC3200X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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