Provider Demographics
NPI:1134386246
Name:ADVANCED ORTHOPAEDIC AND REHABILITATION LLC
Entity type:Organization
Organization Name:ADVANCED ORTHOPAEDIC AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:TALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARTORIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-225-8657
Mailing Address - Street 1:100 TRICH DRIVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-5987
Mailing Address - Country:US
Mailing Address - Phone:724-225-8657
Mailing Address - Fax:724-228-8388
Practice Address - Street 1:100 TRICH DRIVE
Practice Address - Street 2:SUITE 2
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-5987
Practice Address - Country:US
Practice Address - Phone:724-225-8657
Practice Address - Fax:724-228-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD045825L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021479530002Medicaid
PA127742Medicare Oscar/Certification