Basic Information
| Provider Information | |||||||||
| NPI: | 1518269760 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORTHOPAEDIC ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 RESERVOIR AVE | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029104448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4019443800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2138 MENDON RD | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | CUMBERLAND | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02864 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013341060 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2010 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| AuthorizedOfficialLastName: | MARIORENZI | ||||||||
| AuthorizedOfficialFirstName: | AMEDEO | ||||||||
| AuthorizedOfficialMiddleName: | LOUIS | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4019443800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | RI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0382210001 | 01 | RI | DURABLE MED. EQUIP/ NHIC | OTHER |