Provider Demographics
NPI:1548466980
Name:LN SOTOS MD. ORTHOPAEDIC ASSOCIATES INC.
Entity type:Organization
Organization Name:LN SOTOS MD. ORTHOPAEDIC ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGER
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:724-548-4120
Mailing Address - Street 1:179 N PARK DR STE 2
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7121
Mailing Address - Country:US
Mailing Address - Phone:724-548-4120
Mailing Address - Fax:724-545-3421
Practice Address - Street 1:179 N PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7121
Practice Address - Country:US
Practice Address - Phone:724-548-4120
Practice Address - Fax:724-545-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012272-E261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0679667Medicaid
PA0679667Medicaid
PAB33406Medicare UPIN