Basic Information
| Provider Information | |||||||||
| NPI: | 1376615138 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEEL VALLEY ORTHOPAEDICS & SPORTS MEDICINE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 BROOKS LN | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253747 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124691660 | ||||||||
| FaxNumber: | 4124698972 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 BROOKS LN | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | CLAIRTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124691660 | ||||||||
| FaxNumber: | 4124698972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 02/03/2017 | ||||||||
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| AuthorizedOfficialLastName: | LLOYD | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4124691660 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | PA | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 207X00000X | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1026655560001 | 05 | PA | MEDICAID | 1026655560002 | 05 | PA | MEDICAID |