MEDICARE: ALLEGHENY REGIONAL BONE AND JOINT SURGERY PC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1972826873
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY REGIONAL BONE AND JOINT SURGERY PC

Provider Business Mailing Address
First Line	:	908 NIAGARA FALLS BLVD
Second Line	:	SUITE 208
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-2019
Country	:	US
Telephone Number	:	716-692-3302
Fax Number	:

Provider Business Practice Location Address
First Line	:	2626 W STATE ST STE 700
Second Line	:	HOLIDAY PARK CENTRE
City	:	OLEAN
State	:	NY
Zip	:	14760-1858
Country	:	US
Telephone Number	:	716-373-1590
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PETER TERHAAR
Credential	:	DO
Telephone Number	:	716-373-1590

Provider Enumeration Date	:	03/05/2010
Last Update Date	:	09/24/2015

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