Healthcare Provider Details

I. General information

NPI: 1457803702
Provider Name (Legal Business Name): ADVANCED ORTHOPEDICS NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2016
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JOLLEY DR SUITE 301
BLOOMFIELD CT
06002-3062
US

IV. Provider business mailing address

1000 ASYLUM AVE STE 2126
HARTFORD CT
06105-1719
US

V. Phone/Fax

Practice location:
  • Phone: 860-728-6740
  • Fax:
Mailing address:
  • Phone: 860-728-6740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DAVID KRUGER
Title or Position: PHYSICIAN
Credential: MD
Phone: 860-728-6740