Basic Information
| Provider Information | |||||||||
| NPI: | 1851792360 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MON-VALE ORTHOPEDICS INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE ORTHOPEDIC GROUP | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 PLAZA DR | ||||||||
| Address2: | STE 240 | ||||||||
| City: | BELLE VERNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150124019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243795816 | ||||||||
| FaxNumber: | 7243795874 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MEDICAL BLVD | ||||||||
| Address2: | STE 150 | ||||||||
| City: | CANONSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153179762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7243795816 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2014 | ||||||||
| LastUpdateDate: | 09/16/2014 | ||||||||
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| AuthorizedOfficialLastName: | PRESSMAN | ||||||||
| AuthorizedOfficialFirstName: | ARI | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7243795816 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 213ES0103X | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.