Healthcare Provider Details

I. General information

NPI: 1295889970
Provider Name (Legal Business Name): HARTFORD ORTHOPAEDIC PLASTIC & HAND SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 HEBRON AVE STE 205
GLASTONBURY CT
06033-2421
US

IV. Provider business mailing address

195 EASTERN BLVD SUITE 200
GLASTONBURY CT
06033-1208
US

V. Phone/Fax

Practice location:
  • Phone: 860-527-7161
  • Fax:
Mailing address:
  • Phone: 860-527-7161
  • Fax: 860-728-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1004951000
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number StateCT

VIII. Authorized Official

Name: RACHEL PERRY
Title or Position: PROGRAM MANAGER
Credential:
Phone: 860-781-6294