Healthcare Provider Details

I. General information

NPI: 1881631612
Provider Name (Legal Business Name): NORTHWEST ORTHOPAEDIC SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PINETOWN RD
FT WASHINGTON PA
19034-2605
US

IV. Provider business mailing address

550 PINETOWN RD
FT WASHINGTON PA
19034-2605
US

V. Phone/Fax

Practice location:
  • Phone: 267-462-4877
  • Fax: 267-472-4878
Mailing address:
  • Phone: 267-462-4877
  • Fax: 267-472-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StatePA

VIII. Authorized Official

Name: MRS. CAROL A PRINCE
Title or Position: MANAGER
Credential:
Phone: 267-462-4877