Provider Demographics
NPI:1932256914
Name:FOUR SEASONS ORTHOPEDIC CENTER PA
Entity Type:Organization
Organization Name:FOUR SEASONS ORTHOPEDIC CENTER PA
Other - Org Name:THE ORTHOPEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCAFIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-883-0091
Mailing Address - Street 1:17 RIVERSIDE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1304
Mailing Address - Country:US
Mailing Address - Phone:603-883-0091
Mailing Address - Fax:603-881-3739
Practice Address - Street 1:35 KOSCIUSZKO ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1608
Practice Address - Country:US
Practice Address - Phone:603-634-0080
Practice Address - Fax:603-634-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHRE3689Medicare PIN
NH0132510002Medicare NSC