Healthcare Provider Details

I. General information

NPI: 1184089609
Provider Name (Legal Business Name): RECONSTRUCTIVE ORTHOPAEDIC ASSOCIATES II, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST 5TH FLOOR
PHILADELPHIA PA
19107-4216
US

IV. Provider business mailing address

833 CHESTNUT ST SUITE 1402
PHILADELPHIA PA
19107-4414
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-9999
  • Fax: 267-339-3500
Mailing address:
  • Phone: 800-321-9999
  • Fax: 267-339-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SEBRINA MEJIAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 267-339-3769