| Organization Name: | FIRST AVEUNUE OCCUPATIONAL MEDICINE,LLC |
| NPI Number: | 1093831414 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EDWRAD ORUCH (DIRECTOR OF PHYSICAL THERAPY) |
| Mailing Address: | 860 1st Ave Suite870 King Of Prussia |
| State: | PA US |
| Postal Code: | 194061404 |
| Phone Number: | 6102653200 |
| Fax Number: | 6102656522 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | PT005823L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |