Provider Demographics
NPI:1073570701
Name:LN SOTOS ORTHOPAEDIC ASSOCIATES PC
Entity Type:Organization
Organization Name:LN SOTOS ORTHOPAEDIC ASSOCIATES PC
Other - Org Name:DR LAZAROS N SOTOS PHYSICIAN
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZAROS
Authorized Official - Middle Name:N
Authorized Official - Last Name:SOTOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-548-4120
Mailing Address - Street 1:179 N PARK DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7117
Mailing Address - Country:US
Mailing Address - Phone:724-548-4120
Mailing Address - Fax:724-545-3421
Practice Address - Street 1:179 N PARK DR
Practice Address - Street 2:SUITE #2
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7117
Practice Address - Country:US
Practice Address - Phone:724-548-4120
Practice Address - Fax:724-545-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012272E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0679667Medicaid
PAS019573OtherBSP
PAS019573OtherBSP
118723Medicare PIN