1376514943 NPI number — PENNSYLVANIA ORTHOPEDIC ASSOCIATES INC

Table of content: (NPI 1376514943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376514943 NPI number — PENNSYLVANIA ORTHOPEDIC ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PENNSYLVANIA ORTHOPEDIC 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:
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:
1376514943
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 WELSH RD
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006-6357
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-947-7550
Provider Business Mailing Address Fax Number:
215-947-0590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
727 WELSH RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HUNTINGDON VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19006-6357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-947-7550
Provider Business Practice Location Address Fax Number:
215-947-0590
Provider Enumeration Date:
01/31/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KRUM
Authorized Official First Name:
SETH
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
215-947-7550

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 182543 . This is a "HIGHMARK BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: CE8429 . This is a "TRAVELERS MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".