Healthcare Provider Details

I. General information

NPI: 1699129957
Provider Name (Legal Business Name): VALLEY ORTHOPAEDIC SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 04/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 POST RD SUITE 208
FAIRFIELD CT
06824-6015
US

IV. Provider business mailing address

2 TRAP FALLS RD SUITE 404
SHELTON CT
06484-4616
US

V. Phone/Fax

Practice location:
  • Phone: 203-734-7900
  • Fax: 203-513-3267
Mailing address:
  • Phone: 203-734-7900
  • Fax: 203-513-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number033733
License Number StateCT

VIII. Authorized Official

Name: JONICA CIAGLIA
Title or Position: PRACTICE ADMINISTRATOR
Credential: ATC
Phone: 203-734-7900