Healthcare Provider Details
I. General information
NPI: 1477600864
Provider Name (Legal Business Name): EASTERN PENNSYLVANIA ORTHOPEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
255 S 17TH ST FL 30
PHILADELPHIA PA
19103-6207
US
IV. Provider business mailing address
255 S 17TH ST FL 30
PHILADELPHIA PA
19103-6207
US
V. Phone/Fax
- Phone: 215-735-5911
- Fax:
- Phone: 215-735-5911
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | OS003472L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
CYNTHIA
LEE
PIERAMI
Title or Position: MANAGER
Credential:
Phone: 215-735-5911