Basic Information
| Provider Information | |||||||||
| NPI: | 1649603317 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ORTHOPEDIC & NEUROLOGICAL CONSULTANTS, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ORTHONEURO | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70 S CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | WESTERVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430811397 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148906555 | ||||||||
| FaxNumber: | 6148238881 | ||||||||
| Practice Location | |||||||||
| Address1: | 6770 AVERY MUIRFIELD DR | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430171241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148906555 | ||||||||
| FaxNumber: | 6148238881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2013 | ||||||||
| LastUpdateDate: | 09/18/2013 | ||||||||
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| AuthorizedOfficialLastName: | BERASI | ||||||||
| AuthorizedOfficialFirstName: | CARL | ||||||||
| AuthorizedOfficialMiddleName: | C. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6148906555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.O. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | OH | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.