Healthcare Provider Details

I. General information

NPI: 1760657712
Provider Name (Legal Business Name): LITCHFIELD HILLS ORTHOPEDIC ASSOCIATES, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 10/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 N MAIN ST
BRISTOL CT
06010-4971
US

IV. Provider business mailing address

245 ALVORD PARK RD
TORRINGTON CT
06790-3493
US

V. Phone/Fax

Practice location:
  • Phone: 860-582-0822
  • Fax: 860-582-0204
Mailing address:
  • Phone: 860-482-8539
  • Fax: 860-482-0258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHANAEL T. TRYTHALL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 860-496-4160