Healthcare Provider Details
I. General information
NPI: 1750420048
Provider Name (Legal Business Name): ORTHOCONNECTICUT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2007
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
90 GROVE ST STE 107
RIDGEFIELD CT
06877-4129
US
IV. Provider business mailing address
18444 N 25TH AVE STE 320
PHOENIX AZ
85023-1266
US
V. Phone/Fax
- Phone: 203-797-1500
- Fax:
- Phone: 623-241-8730
- Fax: 623-544-5531
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
SIROIS
Title or Position: CEO
Credential:
Phone: 203-702-6603