Provider Demographics
NPI:1972338721
Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Entity type:Organization
Organization Name:CENTERS FOR ADVANCED ORTHOPAEDICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GROSSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-644-1880
Mailing Address - Street 1:8525 ROLLING RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3673
Mailing Address - Country:US
Mailing Address - Phone:703-393-1667
Mailing Address - Fax:703-393-2517
Practice Address - Street 1:8525 ROLLING RD STE 300
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3673
Practice Address - Country:US
Practice Address - Phone:703-393-1667
Practice Address - Fax:703-393-2517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty