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General NPI Number Information
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NPI Number | 1942096409
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Entity Type | Organization
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Legal Business Name | IRON MOUNTAIN ORTHOPAEDIC INSTITUTE
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 2138 COUNTY LINE RD
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-1740
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Country | US
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Telephone | 215-821-7059
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Fax | 267-794-8077
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Provider Business Mailing Address
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Address Line | 2138 COUNTY LINE RD
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-1740
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Country | US
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Telephone |
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Fax | 267-794-8077
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Authorized Official
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Title or Position | CEO
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Name | MARK AYZENBERG
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Credential | MD
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Telephone | 215-821-7059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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