Basic Information
| Provider Information | |||||||||
| NPI: | 1235504598 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ROTHMAN INSTITUTE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 833 CHESTNUT ST | ||||||||
| Address2: | SUITE 1402 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191074414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003219999 | ||||||||
| FaxNumber: | 2673393763 | ||||||||
| Practice Location | |||||||||
| Address1: | 1327 OLD YORK RD | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158308700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2015 | ||||||||
| LastUpdateDate: | 12/11/2015 | ||||||||
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| AuthorizedOfficialLastName: | WEST | ||||||||
| AuthorizedOfficialFirstName: | MIKE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2673393500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 335E00000X | Y | Suppliers | Prosthetic/Orthotic Supplier |
No ID Information.