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General NPI Number Information
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NPI Number | 1427533959
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Entity Type | Organization
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Legal Business Name | SOMERS ORTHOPAEDIC SURGERY & SPORTS MEDICINE GROUP PLLC
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Dates
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Enumeration Date | 10/01/2018
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 40 OLD RIDGEBURY RD STE 101
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City | DANBURY
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State | CT
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Zip | 06810-5123
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Country | US
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Telephone | 203-397-6872
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Fax | 203-207-0304
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Provider Business Mailing Address
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Address Line | 40 OLD RIDGEBURY RD STE 101
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City | DANBURY
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State | CT
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Zip | 06810-5123
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Country | US
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Telephone | 203-397-6872
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Fax | 203-207-0304
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Authorized Official
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Title or Position | OWNER
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Name | JOEL BUCHALTER
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Credential | MD
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Telephone | 845-230-5121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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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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