Provider Demographics
NPI:1386694396
Name:ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.
Entity type:Organization
Organization Name:ORTHOPEDIC AND SPORTS PHYSICAL THERAPY SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:OSTROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-629-3837
Mailing Address - Street 1:420 BAINBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1568
Mailing Address - Country:US
Mailing Address - Phone:215-629-3837
Mailing Address - Fax:215-629-5531
Practice Address - Street 1:331 WILMINGTON PIKE
Practice Address - Street 2:SUITE 1
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-2277
Practice Address - Country:US
Practice Address - Phone:610-558-5866
Practice Address - Fax:610-558-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA966448OtherBCBS PPO GROUP#
PA118100606OtherUS DEPT OF LABOR
PA0213006OtherORTHONET
PA0444631000OtherBCBS HMO GROUP #
PA99493OtherAETNA HMO GROUP#
PA4566762OtherAETNA PPO GROUP#
PA99493OtherAETNA HMO GROUP#