Provider Demographics
NPI:1922502095
Name:SC ORTHOPEDICS OF NEW ENGLAND,PC.
Entity Type:Organization
Organization Name:SC ORTHOPEDICS OF NEW ENGLAND,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WORTHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-763-1114
Mailing Address - Street 1:520 8TH ST NE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5118
Mailing Address - Country:US
Mailing Address - Phone:413-452-6251
Mailing Address - Fax:413-452-6259
Practice Address - Street 1:401 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3404
Practice Address - Country:US
Practice Address - Phone:413-452-6251
Practice Address - Fax:413-452-6259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty