Provider Demographics
NPI:1609120021
Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES, II, PC
Entity Type:Organization
Organization Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES, II, PC
Other - Org Name:ROTHMAN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-339-3680
Mailing Address - Street 1:235 W LANCASTER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1560
Mailing Address - Country:US
Mailing Address - Phone:610-688-6767
Mailing Address - Fax:610-688-3224
Practice Address - Street 1:235 W LANCASTER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1560
Practice Address - Country:US
Practice Address - Phone:610-688-6767
Practice Address - Fax:610-688-3224
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES, II, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-07
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier