Basic Information
Provider Information
NPI: 1679807432
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: 3300 TILLMAN DR
Address2: SECOND FLOOR
City: BENSALEM
State: PA
PostalCode: 190202071
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber:  
Practice Location
Address1: 3300 TILLMAN DR
Address2: SECOND FLOOR
City: BENSALEM
State: PA
PostalCode: 190202071
CountryCode: US
TelephoneNumber: 8003219999
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/28/2009
LastUpdateDate: 04/10/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEST
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: E.
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2673393680
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
335E00000X  Y SuppliersProsthetic/Orthotic Supplier 

No ID Information.


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