Healthcare Provider Details

I. General information

NPI: 1760158612
Provider Name (Legal Business Name): CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2021
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2470 LONGSTONE LN STE K
MARRIOTTSVILLE MD
21104-1515
US

IV. Provider business mailing address

6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US

V. Phone/Fax

Practice location:
  • Phone: 410-442-2470
  • Fax:
Mailing address:
  • Phone: 301-637-8712
  • Fax: 301-547-3366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS PATRICK GROSSO
Title or Position: PRINCIPLE PHYSICIAN
Credential:
Phone: 410-644-1880