Healthcare Provider Details

I. General information

NPI: 1215877238
Provider Name (Legal Business Name): ORTHOPAEDIC & NEUROSURGERY SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 SPENCER PLAIN RD
OLD SAYBROOK CT
06475
US

IV. Provider business mailing address

5 HIGH RIDGE PARK FL 2
STAMFORD CT
06905-1332
US

V. Phone/Fax

Practice location:
  • Phone: 860-347-7636
  • Fax: 860-894-1894
Mailing address:
  • Phone: 203-869-1145
  • Fax: 203-618-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIBETH CHACH
Title or Position: ADMIN
Credential:
Phone: 845-454-0120