Provider Demographics
NPI:1770829830
Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Entity Type:Organization
Organization Name:PREMIER ORTHOPAEDIC AND SPORTS MEDICINE ASSOCIATES LTD
Other - Org Name:EXTON PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PREISIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-521-9996
Mailing Address - Street 1:525 W CHESTER PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4500
Mailing Address - Country:US
Mailing Address - Phone:610-446-8410
Mailing Address - Fax:610-446-8554
Practice Address - Street 1:491 JOHN YOUNG WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2567
Practice Address - Country:US
Practice Address - Phone:610-524-7251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty