Healthcare Provider Details

I. General information

NPI: 1073331609
Provider Name (Legal Business Name): HARTFORD ORTHOPEDIC MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 W MAIN ST
NEW BRITAIN CT
06052-1315
US

IV. Provider business mailing address

136 W MAIN ST FL 3
NEW BRITAIN CT
06052-1315
US

V. Phone/Fax

Practice location:
  • Phone: 203-565-5104
  • Fax: 860-826-4762
Mailing address:
  • Phone: 860-800-2859
  • Fax: 860-826-4762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2081N0008X
TaxonomyNeuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: ERIC VOIDE
Title or Position: LLC MEMBER
Credential:
Phone: 860-800-2859