MEDICARE: ORTHONET OF THE MID-ATLANTIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization
2	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1093043788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHONET OF THE MID-ATLANTIC, INC.

Provider Business Mailing Address
First Line	:	1311 MAMARONECK AVE STE 240
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5222
Country	:	US
Telephone Number	:	914-681-8800
Fax Number	:	914-681-8899

Provider Business Practice Location Address
First Line	:	1311 MAMARONECK AVE STE 240
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5222
Country	:	US
Telephone Number	:	914-681-8800
Fax Number	:	914-681-8899

Authorized Official
Title or Position	:	SECRETARY, EXECUTIVE VICE PRESIDENT
Name	:	MR. MICHAEL H. SINGER
Credential	:
Telephone Number	:	914-681-8800

Provider Enumeration Date	:	11/18/2009
Last Update Date	:	11/18/2009

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