Healthcare Provider Details

I. General information

NPI: 1194773382
Provider Name (Legal Business Name): CONNECTICUT ORTHOPAEDIC AND HAND SURGERY CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FOUNDERS ST. SUITE 202
WILLIMANTIC CT
06226
US

IV. Provider business mailing address

99 EAST RIVER DR. 5TH FLOOR
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 860-456-3997
  • Fax: 860-450-7323
Mailing address:
  • Phone: 860-282-4133
  • Fax: 860-289-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN SCARANGELLA
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 860-456-3997