1548268600 NPI number — ORTHOPEDIC PHYSICAL THERAPY SPECIALISTS, INC.

Table of content: (NPI 1548268600)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548268600 NPI number — ORTHOPEDIC PHYSICAL THERAPY SPECIALISTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC PHYSICAL THERAPY SPECIALISTS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548268600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1150 GLENLIVET DR
Provider Second Line Business Mailing Address:
SUITE A14
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18106-3112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-336-4300
Provider Business Mailing Address Fax Number:
610-336-0971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1150 GLENLIVET DR
Provider Second Line Business Practice Location Address:
SUITE A14
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18106-3112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-336-4300
Provider Business Practice Location Address Fax Number:
610-336-0971
Provider Enumeration Date:
07/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SHEAFFER
Authorized Official First Name:
KARL
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-336-4300

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  PT006278L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1596860 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50033390 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1784211 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3000107 . This is a "KEYSTONEHEALTHPLANCENTRAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3488496 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: OR1596860 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 245899 . This is a "HEALTH ASSURANCE AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3000107 . This is a "SENIOR BLUE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 96513 . This is a "GEISINGER HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2278874000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2278874000 . This is a "KEYSTONEHEALTHPLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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