Provider Demographics
NPI:1821254319
Name:THE CENTER OF ORTHOPEDIC SURGERY
Entity Type:Organization
Organization Name:THE CENTER OF ORTHOPEDIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LOPRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-581-5555
Mailing Address - Street 1:1 INFINITY CORPORATE CENTRE DR
Mailing Address - Street 2:SUITE 160
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5369
Mailing Address - Country:US
Mailing Address - Phone:216-581-5555
Mailing Address - Fax:216-518-2968
Practice Address - Street 1:6789 RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5649
Practice Address - Country:US
Practice Address - Phone:440-845-6400
Practice Address - Fax:440-845-6835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2243727Medicaid