Healthcare Provider Details

I. General information

NPI: 1154516748
Provider Name (Legal Business Name): FARMINGTON VALLEY ORTHOPEDIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 DALE RD
AVON CT
06001
US

IV. Provider business mailing address

34 DALE RD
AVON CT
06001-3659
US

V. Phone/Fax

Practice location:
  • Phone: 860-677-0079
  • Fax: 860-677-4785
Mailing address:
  • Phone: 860-677-0079
  • Fax: 860-677-4785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN BOND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-677-0079