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General NPI Number Information
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NPI Number | 1679646905
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Entity Type | Organization
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Legal Business Name | ADVANCED HAND ORTHOPEDIC & SPORTS MEDICINE CENTER, L.L.C.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 11/01/2007
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Provider Practice Location Address
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Address Line | 447 OFFICE PLAZA 500 PLAZA COURT, STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301
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Country | US
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Telephone | 570-424-5180
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Fax | 570-421-8432
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Provider Business Mailing Address
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Address Line | 447 OFFICE PLAZA 500 PLAZA COURT, STE D
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City | EAST STROUDSBURG
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State | PA
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Zip | 18301
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Country | US
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Telephone | 570-424-5180
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Fax | 570-421-8432
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE A PRIMIANO
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Credential | MD
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Telephone | 570-424-5180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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