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General NPI Number Information
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NPI Number | 1225237662
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOPAEDICS, LLC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 450 BOSTON POST RD
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City | GUILFORD
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State | CT
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Zip | 06437-2933
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Country | US
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Telephone | 203-453-5368
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Fax | 203-453-5381
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Provider Business Mailing Address
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Address Line | 450 BOSTON POST RD
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City | GUILFORD
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State | CT
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Zip | 06437-2933
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Country | US
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Telephone | 203-453-5368
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Fax | 203-453-5381
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SANDA TOMAK
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Credential | MD
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Telephone | 203-453-5368
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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 | 042350
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License Number State | CT
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