MEDICARE: SIDNEY HILLMAN ORTHO

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	261Q00000X	Clinic/Center	MD024995E	PA

General Provider Information

NPI Number	:	1891024436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIDNEY HILLMAN ORTHO

Provider Business Mailing Address
First Line	:	2116 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4401
Country	:	US
Telephone Number	:	215-568-4080
Fax Number	:	215-568-4088

Provider Business Practice Location Address
First Line	:	2116 CHESTNUT ST
Second Line	:	2ND FLOOR
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4401
Country	:	US
Telephone Number	:	215-568-4080
Fax Number	:	215-568-4088

Authorized Official
Title or Position	:	MANAGER
Name	:	JOHANNA HERNANDEZ
Credential	:
Telephone Number	:	215-568-4080

Provider Enumeration Date	:	12/10/2009
Last Update Date	:	12/10/2009

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Directions to “SIDNEY HILLMAN ORTHO ” Practice Location

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