Healthcare Provider Details

I. General information

NPI: 1285676825
Provider Name (Legal Business Name): ORTHOPEDIC ASSOCIATES OF CENTRAL CONNECTICUT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 COTTAGE GROVE RD
BLOOMFIELD CT
06002
US

IV. Provider business mailing address

510 COTTAGE GROVE RD
BLOOMFIELD CT
06002-3123
US

V. Phone/Fax

Practice location:
  • Phone: 860-243-1414
  • Fax: 860-286-0510
Mailing address:
  • Phone: 860-243-1414
  • Fax: 860-286-0510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN E. SELDEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-243-1414