Provider Demographics
NPI:1932292091
Name:ORTHOPEDIC ASSOCIATES OF THE GREATER LEHIGH VALLEY
Entity Type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF THE GREATER LEHIGH VALLEY
Other - Org Name:AQUATIC & PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LOGUIDICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-252-1600
Mailing Address - Street 1:3735 EASTON NAZARETH HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-252-2700
Mailing Address - Fax:610-250-9257
Practice Address - Street 1:3735 EASTON NAZARETH HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-252-2700
Practice Address - Fax:610-250-9257
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC ASSOCIATES OF THE GREATER LEHIGH VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH6387Medicare PIN
NJCL6906Medicare PIN
NJ445884Medicare PIN
PA086766Medicare PIN