Basic Information
Provider Information
NPI: 1134623705
EntityType: 2
ReplacementNPI:  
OrganizationName: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
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Mailing Information
Address1: 833 CHESTNUT ST STE 520
Address2:  
City: PHILA
State: PA
PostalCode: 191074414
CountryCode: US
TelephoneNumber: 2673393543
FaxNumber:  
Practice Location
Address1: 3300 TILLMAN DR FL 2
Address2:  
City: BENSALEM
State: PA
PostalCode: 190202071
CountryCode: US
TelephoneNumber: 2156426900
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/20/2018
LastUpdateDate: 03/20/2018
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AuthorizedOfficialLastName: PINO
AuthorizedOfficialFirstName: GINA
AuthorizedOfficialMiddleName: MARIE
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 2673393500
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IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X PAY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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