Provider Demographics
NPI:1386727352
Name:ORTHOPEDIC SERVICES & SPORTS MEDICINE, INC.
Entity type:Organization
Organization Name:ORTHOPEDIC SERVICES & SPORTS MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIZZARELLO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:401-273-8400
Mailing Address - Street 1:868 ADMIRAL ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-1917
Mailing Address - Country:US
Mailing Address - Phone:401-273-8400
Mailing Address - Fax:401-273-9420
Practice Address - Street 1:868 ADMIRAL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-1917
Practice Address - Country:US
Practice Address - Phone:401-273-8400
Practice Address - Fax:401-273-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5773660001OtherMEDICARE DME
5773660001Medicare NSC