Healthcare Provider Details

I. General information

NPI: 1659645836
Provider Name (Legal Business Name): UNIVERSITY ORTHOPEDICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 11/15/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 VALLEY RD.
MIDDLETOWN RI
02842
US

IV. Provider business mailing address

PO BOX 1119
PROVIDENCE RI
02901-1119
US

V. Phone/Fax

Practice location:
  • Phone: 401-457-1500
  • Fax:
Mailing address:
  • Phone: 401-330-1475
  • Fax: 401-831-6054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: WEBER SHILL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MBA
Phone: 401-457-1504