Provider Demographics
NPI:1558323345
Name:CENTER OF ORTHOPEDIC SURGERY INC
Entity type:Organization
Organization Name:CENTER OF ORTHOPEDIC SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LOPRESTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-581-8570
Mailing Address - Street 1:1 INFINITY CORPORATE CENTRE DR
Mailing Address - Street 2:STE 160
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2933
Mailing Address - Country:US
Mailing Address - Phone:216-581-5555
Mailing Address - Fax:216-518-2968
Practice Address - Street 1:1 INFINITY CORPORATE CENTRE DR
Practice Address - Street 2:STE 160
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2933
Practice Address - Country:US
Practice Address - Phone:216-581-5555
Practice Address - Fax:216-518-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0136105Medicaid
OH0136105Medicaid
OH9249672Medicare PIN