Healthcare Provider Details

I. General information

NPI: 1427147826
Provider Name (Legal Business Name): ORTHOPAEDIC SURGERY CENTERS, PC II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5838 HARBOUR VIEW BLVD SUITE 100
SUFFOLK VA
23435-2663
US

IV. Provider business mailing address

PO BOX 7848
PORTSMOUTH VA
23707-0848
US

V. Phone/Fax

Practice location:
  • Phone: 757-483-0407
  • Fax: 757-483-3075
Mailing address:
  • Phone: 757-398-0779
  • Fax: 757-398-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY A. COLOGGI
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 757-397-9015