Provider Demographics
NPI:1053313262
Name:SYLVA ORTHOPAEDIC ASSOCIATES, PA
Entity Type:Organization
Organization Name:SYLVA ORTHOPAEDIC ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:SUPIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-586-5531
Mailing Address - Street 1:80 HEALTHCARE DR
Mailing Address - Street 2:STE 203
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5146
Mailing Address - Country:US
Mailing Address - Phone:828-586-5531
Mailing Address - Fax:828-586-5759
Practice Address - Street 1:80 HEALTHCARE DR
Practice Address - Street 2:STE 203
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5146
Practice Address - Country:US
Practice Address - Phone:828-586-5531
Practice Address - Fax:828-586-5759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC40411332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0364340001OtherMEDICARE DMERC REGION C
NC0364340001Medicare NSC
NC0778Medicare PIN