Provider Demographics
NPI:1356677207
Name:MONVALE ORTHOPEDICS, INC.
Entity Type:Organization
Organization Name:MONVALE ORTHOPEDICS, INC.
Other - Org Name:THE ORTHOPEDIC GROUP, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMADNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-379-5802
Mailing Address - Street 1:800 PLAZA DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-4019
Mailing Address - Country:US
Mailing Address - Phone:724-379-5816
Mailing Address - Fax:724-379-5874
Practice Address - Street 1:104 DELAWARE AVE STE 100
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3100
Practice Address - Country:US
Practice Address - Phone:724-425-0300
Practice Address - Fax:724-425-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6689060002Medicare NSC