1396775367 NPI number — ORTHOPAEDIC ASSOCIATES OF ALLENTOWN

Table of content: (NPI 1396775367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396775367 NPI number — ORTHOPAEDIC ASSOCIATES OF ALLENTOWN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPAEDIC ASSOCIATES OF ALLENTOWN
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:
6
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:
1396775367
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 CETRONIA ROAD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-9168
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-973-6200
Provider Business Mailing Address Fax Number:
610-973-6534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4652 BROADWAY STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-3214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-386-9910
Provider Business Practice Location Address Fax Number:
610-973-6489
Provider Enumeration Date:
07/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BITTNER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
610-973-6200

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: 002346400 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: AETNA . This is a "54707" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 797893 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 797893 . This is a "KEYSTONE CENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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