Basic Information
| Provider Information | |||||||||
| NPI: | 1316469927 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED ORTHOPEDICS NEW ENGLAND | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 ASYLUM AVE STE 2126 | ||||||||
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| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061051719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607286740 | ||||||||
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| Practice Location | |||||||||
| Address1: | 893 MAIN ST STE 301 | ||||||||
| Address2: | |||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061082293 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607286740 | ||||||||
| FaxNumber: | 8605471554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2017 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | GORMAN | ||||||||
| AuthorizedOfficialFirstName: | KRIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8607286740 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.