Basic Information
Provider Information
NPI: 1245626985
EntityType: 2
ReplacementNPI:  
OrganizationName: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 3855 W CHESTER PIKE
Address2: SUITE 340
City: NEWTOWN SQUARE
State: PA
PostalCode: 190732304
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber:  
Practice Location
Address1: 3855 W CHESTER PIKE
Address2: SUITE 340
City: NEWTOWN SQUARE
State: PA
PostalCode: 190732304
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber: 6107074025
Other Information
ProviderEnumerationDate: 04/09/2015
LastUpdateDate: 06/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEST
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: E
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2673393500
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
335E00000X  Y SuppliersProsthetic/Orthotic Supplier 

No ID Information.


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