Healthcare Provider Details

I. General information

NPI: 1083643126
Provider Name (Legal Business Name): TRIBURY ORTHOPAEDICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CHASE PKWY
WATERBURY CT
06708-3346
US

IV. Provider business mailing address

500 CHASE PKWY
WATERBURY CT
06708-3346
US

V. Phone/Fax

Practice location:
  • Phone: 203-755-4281
  • Fax: 203-755-7166
Mailing address:
  • Phone: 203-755-4281
  • Fax: 203-755-7166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID C. NESS
Title or Position: ADMINISTRATOR
Credential:
Phone: 203-755-4281