Healthcare Provider Details

I. General information

NPI: 1457321796
Provider Name (Legal Business Name): DANIEL M VELTRI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 TOLLAND TPKE SUITE 3-C
MANCHESTER CT
06042-1771
US

IV. Provider business mailing address

99 EAST RIVER DR 5TH FL
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 860-649-0063
  • Fax:
Mailing address:
  • Phone: 860-282-4022
  • Fax: 860-289-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number030404
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number030404
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number030404
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number030404
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: