Provider Demographics
NPI:1740507912
Name:KEYSTONE ORTHOPAEDIC SPECIALISTS
Entity type:Organization
Organization Name:KEYSTONE ORTHOPAEDIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-376-5600
Mailing Address - Street 1:1270 BROADCASTING RD
Mailing Address - Street 2:REAR
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3203
Mailing Address - Country:US
Mailing Address - Phone:610-376-5600
Mailing Address - Fax:610-372-7684
Practice Address - Street 1:1270 BROADCASTING RD
Practice Address - Street 2:REAR
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3203
Practice Address - Country:US
Practice Address - Phone:610-376-5600
Practice Address - Fax:610-372-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies