MEDICARE: CONNECTICUT ORTHOPEDIC SERVICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier		CT

General Provider Information

NPI Number	:	1578652335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTICUT ORTHOPEDIC SERVICE, INC.

Provider Business Mailing Address
First Line	:	942 NEW BRITAIN AVE
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06110-2228
Country	:	US
Telephone Number	:	860-953-5480
Fax Number	:	860-953-6742

Provider Business Practice Location Address
First Line	:	942 NEW BRITAIN AVE
Second Line	:
City	:	WEST HARTFORD
State	:	CT
Zip	:	06110-2228
Country	:	US
Telephone Number	:	860-953-5480
Fax Number	:	860-953-6742

Authorized Official
Title or Position	:	PRESIDENT
Name	:	WILLI VEITH
Credential	:	CPO
Telephone Number	:	860-953-5480

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/22/2020

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