Provider Demographics
NPI:1821334905
Name:PREMIER ORTHOPEADIC AND SPORTS MEDICINE ASSOC LTD
Entity Type:Organization
Organization Name:PREMIER ORTHOPEADIC AND SPORTS MEDICINE ASSOC LTD
Other - Org Name:PHOENIXVILLE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
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:610-446-8410
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:
Mailing Address - Fax:
Practice Address - Street 1:826 MAIN ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-4459
Practice Address - Country:US
Practice Address - Phone:610-640-4133
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