Provider Demographics
NPI:1588034888
Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAFARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-594-2009
Mailing Address - Street 1:390 WATERLOO BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2603
Mailing Address - Country:US
Mailing Address - Phone:610-594-2009
Mailing Address - Fax:610-594-4780
Practice Address - Street 1:390 WATERLOO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2603
Practice Address - Country:US
Practice Address - Phone:610-594-2009
Practice Address - Fax:610-594-4780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty