Provider Demographics
NPI:1124088810
Name:COMMONWEALTH ORTHOPAEDIC ASSOCIATES PHYSICAL THERAPY
Entity type:Organization
Organization Name:COMMONWEALTH ORTHOPAEDIC ASSOCIATES PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-779-2663
Mailing Address - Street 1:11 FAIRLANE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9567
Mailing Address - Country:US
Mailing Address - Phone:610-779-2663
Mailing Address - Fax:610-779-3367
Practice Address - Street 1:11 FAIRLANE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9567
Practice Address - Country:US
Practice Address - Phone:610-779-2663
Practice Address - Fax:610-779-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-25
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA994354OtherPA BLUE SHIELD
PA994354OtherPA BLUE SHIELD