=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023468436
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS AVERSANO M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2016
-----------------------------------------------------
Last Update Date | 08/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 249 DANBURY RD STE 300
-----------------------------------------------------
City | WILTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06897-4070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 38-691-1452
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 249 DANBURY RD
-----------------------------------------------------
City | WILTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06897-4070
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 203-869-1145
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 01085512A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207XS0106X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Hand Surgery Physician
-----------------------------------------------------
License Number | 314433-01
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207XS0106X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Hand Surgery Physician
-----------------------------------------------------
License Number | 70029
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------