Healthcare Provider Details

I. General information

NPI: 1336221902
Provider Name (Legal Business Name): ORTHOPEDIC ASSOCIATES OF HARTFORD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 HARTFORD TPKE STE 210
VERNON CT
06066-4841
US

IV. Provider business mailing address

270 FARMINGTON AVE SUITE 102
FARMINGTON CT
06032-1909
US

V. Phone/Fax

Practice location:
  • Phone: 860-549-3210
  • Fax: 860-247-3803
Mailing address:
  • Phone: 860-549-8276
  • Fax: 860-674-8084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCT

VIII. Authorized Official

Name: LISA M DEMING
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 860-549-8276