Provider Demographics
NPI:1679807432
Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Entity Type:Organization
Organization Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Other - Org Name:
Other - Org Type:
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 1:3300 TILLMAN DR
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2071
Mailing Address - Country:US
Mailing Address - Phone:800-321-9999
Mailing Address - Fax:
Practice Address - Street 1:3300 TILLMAN DR
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2071
Practice Address - Country:US
Practice Address - Phone:800-321-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-28
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0487840006Medicare NSC