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General NPI Number Information
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NPI Number | 1043568249
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC ASSOCIATES OF HARTFORD,PC
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Dates
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Enumeration Date | 08/17/2012
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Last Update Date | 06/15/2020
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Provider Practice Location Address
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Address Line | 399 FARMINGTON AVE SUITE 110
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City | FARMINGTON
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State | CT
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Zip | 06032-1936
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Country | US
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Telephone | 860-549-8963
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Fax |
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Provider Business Mailing Address
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Address Line | 270 FARMINGTON AVE SUITE 102
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City | FARMINGTON
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State | CT
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Zip | 06032-1909
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Country | US
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Telephone | 860-549-8276
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DAVID J MUDANO
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Credential |
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Telephone | 860-549-8279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number |
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License Number State |
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