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Contact Information

RIDGE AVENUE SPORTS MEDICINE, INC.
1150 GLENLIVET DR
A-21
ALLENTOWN, PA18106-3112
 Phone: 484-664-7700
 Fax: 484-664-7701
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for RIDGE AVENUE SPORTS MEDICINE, INC.

NPI Number 1881987998
LBN Legal business name RIDGE AVENUE SPORTS MEDICINE, INC.
Authorized official MARCY SOCRATES - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/23/2011
Last updated 05/23/2011 - About 15 years ago
Identifiers
PA License # MD025425E
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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