MEDICARE: FAMILY ORTHOPAEDICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	028508	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S383492	OTHER	CT	AMERICAN IMAGING
2	2V6915	OTHER	CT	HEALTHNET
3	1092212	OTHER	CT	AETNA
4	1754659	OTHER	CT	UNITED HEALTHCARE
5	485315	OTHER	CT	CONNECTICARE
6	010028508CT09	OTHER	CT	ANTHEM BCBS
7	0181552	OTHER	CT	CIGNA
8	P2564839	OTHER	CT	OXFORD

General Provider Information

NPI Number	:	1790828184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY ORTHOPAEDICS, LLC

Provider Business Mailing Address
First Line	:	1200 BOSTON POST RD
Second Line	:	SUITE 201-B
City	:	GUILFORD
State	:	CT
Zip	:	06437-2450
Country	:	US
Telephone Number	:	203-453-1088
Fax Number	:	203-458-2980

Provider Business Practice Location Address
First Line	:	12 VILLAGE ST
Second Line	:	SUITE 8
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-3828
Country	:	US
Telephone Number	:	203-453-1088
Fax Number	:	203-458-2980

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES SCHUYLER MARSH
Credential	:	M.D.
Telephone Number	:	203-453-1088

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/22/2020

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Directions to “FAMILY ORTHOPAEDICS, LLC ” Practice Location

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