Provider Demographics
NPI:1902862238
Name:MITRICK POLLACK RUTTER ORTHOPAEDICS LLP
Entity Type:Organization
Organization Name:MITRICK POLLACK RUTTER ORTHOPAEDICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-848-2297
Mailing Address - Street 1:1750 5TH AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2607
Mailing Address - Country:US
Mailing Address - Phone:717-848-2297
Mailing Address - Fax:717-848-2941
Practice Address - Street 1:1750 5TH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2607
Practice Address - Country:US
Practice Address - Phone:717-848-2297
Practice Address - Fax:717-848-2941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA197247Medicare ID - Type UnspecifiedGROUP NUMBER