Provider Demographics
NPI:1710900857
Name:SYNERGY ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:SYNERGY ORTHOPEDICS LLC
Other - Org Name:SYNERGY MEDICAL SUPPLY SYNERGY PATIENT SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAGOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-292-8400
Mailing Address - Street 1:920 GERMANTOWN PIKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-7401
Mailing Address - Country:US
Mailing Address - Phone:610-292-8400
Mailing Address - Fax:610-292-0908
Practice Address - Street 1:920 GERMANTOWN PIKE
Practice Address - Street 2:SUITE 210
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-7401
Practice Address - Country:US
Practice Address - Phone:610-292-8400
Practice Address - Fax:610-292-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000006799332BC3200X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5617100001Medicare NSC