1487604658 NPI number — ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.

Table of content: (NPI 1487604658)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487604658 NPI number — ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, 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:
EXCEL PHYSICAL THERAPY
Provider Other Organization Name Type Code:
3
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:
1487604658
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
420 BAINBRIDGE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19147-1568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-629-3837
Provider Business Mailing Address Fax Number:
215-629-5531

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3370 PROGRESS DR
Provider Second Line Business Practice Location Address:
SUITE K
Provider Business Practice Location Address City Name:
BENSALEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19020-5811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-639-1600
Provider Business Practice Location Address Fax Number:
215-639-8216
Provider Enumeration Date:
05/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
OSTROWSKI
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
215-629-3837

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0213000 . This is a "ORTHONET PROVIDER ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0444631000 . This is a "BCBS HMO GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4566762 . This is a "AETNA PPO GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 966448 . This is a "BCBS PPO GROUP NO." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 118100605 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 99493 . This is a "AETNA HMO GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com