Provider Demographics
NPI:1174758981
Name:THE CENTER FOR ADVANCED WOUND CARE
Entity type:Organization
Organization Name:THE CENTER FOR ADVANCED WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:CAVORSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-373-5500
Mailing Address - Street 1:2201 RIDGEWOOD RD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1189
Mailing Address - Country:US
Mailing Address - Phone:610-373-5500
Mailing Address - Fax:610-373-5600
Practice Address - Street 1:2201 RIDGEWOOD RD
Practice Address - Street 2:SUITE 190
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1189
Practice Address - Country:US
Practice Address - Phone:610-373-5500
Practice Address - Fax:610-373-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016859225100000X
PAPT015079225100000X
PAMD039223L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty