Healthcare Provider Details

I. General information

NPI: 1730281270
Provider Name (Legal Business Name): ORTHOPAEDIC HAND SURGERY AND REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4190 CITY AVE STE 503
PHILADELPHIA PA
19131-1634
US

IV. Provider business mailing address

4190 CITY AVE STE 503
PHILADELPHIA PA
19131-1634
US

V. Phone/Fax

Practice location:
  • Phone: 215-871-1616
  • Fax: 215-871-1628
Mailing address:
  • Phone: 215-871-1616
  • Fax: 215-871-1628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberOS005320L
License Number StatePA

VIII. Authorized Official

Name: DR. TODD MARC KELMAN
Title or Position: PRESIDENT/TEASURER
Credential: DO
Phone: 215-871-1616