1457561847 NPI number — CAPITOL ORTHOPAEDICS AND REHABILITATION, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457561847 NPI number — CAPITOL ORTHOPAEDICS AND REHABILITATION, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITOL ORTHOPAEDICS AND REHABILITATION, LLC
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:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457561847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6000 EXECUTIVE BLVD
Provider Second Line Business Mailing Address:
SUITE 510
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20852-3803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-770-7900
Provider Business Mailing Address Fax Number:
301-770-7904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6000 EXECUTIVE BLVD
Provider Second Line Business Practice Location Address:
SUITE 510
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20852-3803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-770-7900
Provider Business Practice Location Address Fax Number:
301-770-7904
Provider Enumeration Date:
05/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROCKOWER
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
JAY
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
301-770-7900

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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