Healthcare Provider Details

I. General information

NPI: 1750361978
Provider Name (Legal Business Name): MAIN LINE ORTHOPAEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S BRYN MAWR AVE SUITE 200
BRYN MAWR PA
19010-3120
US

IV. Provider business mailing address

101 S BRYN MAWR AVE SUITE 200
BRYN MAWR PA
19010-3120
US

V. Phone/Fax

Practice location:
  • Phone: 610-527-9500
  • Fax: 610-527-9529
Mailing address:
  • Phone: 610-527-9500
  • Fax: 610-527-9529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH V VERNACE
Title or Position: OWNER
Credential:
Phone: 610-527-9500