Healthcare Provider Details

I. General information

NPI: 1427348770
Provider Name (Legal Business Name): ADVANCED ORTHOPEDICS NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 ELM ST SUITE 203
ENFIELD CT
06082
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: 860-547-1554
Mailing address:
  • Phone: 860-728-6740
  • Fax: 860-547-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: DAVID KRUGER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 860-728-6740