Basic Information
Provider Information
NPI: 1730203571
EntityType: 2
ReplacementNPI:  
OrganizationName: OCCUPATIONAL HEALTH CENTERS OF SW PA
LastName:  
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Mailing Information
Address1: 5080 SPECTRUM DRIVE
Address2: SUITE 1200 WEST
City: ADDISON
State: TX
PostalCode: 750014625
CountryCode: US
TelephoneNumber: 8002323550
FaxNumber: 9723878058
Practice Location
Address1: 14A BROAD ST
Address2:  
City: NASHUA
State: NH
PostalCode: 03064
CountryCode: US
TelephoneNumber: 6038892354
FaxNumber: 6038892793
Other Information
ProviderEnumerationDate: 03/19/2007
LastUpdateDate: 06/08/2015
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: HASSETT
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 9723648000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DO
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2000X  N Ambulatory Health Care FacilitiesClinic/CenterPhysical Therapy
261QX0100X  N Ambulatory Health Care FacilitiesClinic/CenterOccupational Medicine
261QH0100X  Y Ambulatory Health Care FacilitiesClinic/CenterHealth Service

No ID Information.


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