Healthcare Provider Details

I. General information

NPI: 1215916085
Provider Name (Legal Business Name): CENTER FOR ORTHOPAEDICS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 TEMPLE ST SUITE 3B
NEW HAVEN CT
06510-2716
US

IV. Provider business mailing address

2200 WHITNEY AVE SUITE 140
HAMDEN CT
06518-3330
US

V. Phone/Fax

Practice location:
  • Phone: 203-752-3100
  • Fax:
Mailing address:
  • Phone: 203-752-3100
  • Fax: 203-752-9291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA CAPONE
Title or Position: H/R - ADMIN.
Credential:
Phone: 203-752-3181