Provider Demographics
NPI:1942402003
Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Entity Type:Organization
Organization Name:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-339-3680
Mailing Address - Street 1:NOVACARE COMPLEX
Mailing Address - Street 2:TWO NOVACARE WAY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145
Mailing Address - Country:US
Mailing Address - Phone:267-546-2993
Mailing Address - Fax:267-546-2961
Practice Address - Street 1:NOVACARE COMPLEX
Practice Address - Street 2:TWO NOVACARE WAY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:267-546-2993
Practice Address - Fax:267-546-2961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-01
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0487840004Medicare NSC