Organization
BRADFORD ORTHOPAEDIC & SPORTS MEDICINE GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHABIR BHAYANI MD (PHYSICIAN)
(814) 368-1010
Entity
Organization
Contact information
Practice address
54 BOYLSTON ST, 2ND FLOOR, BRADFORD, PA 16701-2007
(814) 368-1020
(814) 368-1024
Mailing address
54 BOYLSTON ST, 2ND FLOOR, BRADFORD, PA 16701-2007
(814) 368-1020
(814) 368-1024
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019092890005
—
PA
01
—
CN8714
RAILROAD MEDICARE
PA
01
—
CN8715
RAILROAD MEDICARE
NY
Enumeration date
04/03/2006
Last updated
08/29/2008
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