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General NPI Number Information
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NPI Number | 1982058327
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Entity Type | Organization
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Legal Business Name | WESTERN PENNSYLVANIA ORTHOPEDIC AND SPORTS MEDICINE, INC.
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 1450 SCALP AVE SUITE 1055
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City | JOHNSTOWN
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State | PA
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Zip | 15904-3321
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Country | US
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Telephone | 814-255-6781
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Fax | 814-255-5716
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Provider Business Mailing Address
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Address Line | 2 CELESTE DR
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City | JOHNSTOWN
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State | PA
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Zip | 15905-2832
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Country | US
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Telephone | 814-255-6781
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Fax | 814-255-5716
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON / CORP SECRETARY
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Name | DR. IAN KATZ
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Credential | M.D.
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Telephone | 814-255-6781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 6000007302
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 6000007302
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License Number State | PA
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