Provider Demographics
NPI:1417736950
Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type:Organization
Organization Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GROSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-644-1880
Mailing Address - Street 1:PO BOX 79831
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0831
Mailing Address - Country:US
Mailing Address - Phone:301-475-5555
Mailing Address - Fax:301-475-8535
Practice Address - Street 1:23415 THREE NOTCH RD STE 2026
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:MD
Practice Address - Zip Code:20619-4021
Practice Address - Country:US
Practice Address - Phone:240-530-8188
Practice Address - Fax:240-237-8572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies