Basic Information
| Provider Information | |||||||||
| NPI: | 1477021855 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UNIVERSITY ORTHOPEDICS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1119 | ||||||||
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| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029011119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014434150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1524 ATWOOD AVE STE 140 | ||||||||
| Address2: | |||||||||
| City: | JOHNSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029193288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013516200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2018 | ||||||||
| LastUpdateDate: | 11/05/2018 | ||||||||
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| AuthorizedOfficialLastName: | SEKSCENSKI | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING/ADMINISTRATION | ||||||||
| AuthorizedOfficialTelephone: | 4014434150 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.