Healthcare Provider Details
I. General information
NPI: 1083905319
Provider Name (Legal Business Name): ADVANCED ORTHOPEDICS NEW ENGLAND
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/20/2011
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1084 CROMWELL AVE STE 1
ROCKY HILL CT
06067-3445
US
IV. Provider business mailing address
1084 CROMWELL AVE STE 1
ROCKY HILL CT
06067-3445
US
V. Phone/Fax
- Phone: 860-728-6740
- Fax: 860-547-1554
- Phone: 860-728-6740
- Fax: 860-547-1554
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAVID
KRUGER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 860-728-6740