Healthcare Provider Details
I. General information
NPI: 1366468837
Provider Name (Legal Business Name): ORTHOPAEDIC SPECIALISTS OF CONNECTICUT, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/15/2006
Last Update Date: 12/09/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
60 OLD NEW MILFORD RD SUITE 3E
BROOKFIELD CT
06804-2430
US
IV. Provider business mailing address
60 OLD NEW MILFORD RD SUITE 3E
BROOKFIELD CT
06804-2430
US
V. Phone/Fax
- Phone: 203-775-6205
- Fax: 203-775-2373
- Phone: 203-775-6205
- Fax: 203-775-2373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANTONIO
PAZ
Title or Position: PHYSICIAN
Credential: MD
Phone: 203-775-6205