Basic Information
| Provider Information | |||||||||
| NPI: | 1548591902 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW ENGLAND ORTHOPAEDIC CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 E RIVER DR | ||||||||
| Address2: | 5TH FLOOR | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061083288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602820833 | ||||||||
| FaxNumber: | 8602820834 | ||||||||
| Practice Location | |||||||||
| Address1: | 538 LITCHFIELD ST | ||||||||
| Address2: | SUITE #204 | ||||||||
| City: | TORRINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067906669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8604896363 | ||||||||
| FaxNumber: | 8775043201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2010 | ||||||||
| LastUpdateDate: | 07/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | HAKIM-ZARGAR | ||||||||
| AuthorizedOfficialFirstName: | MARIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8602820833 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 044065 | DC | N | Suppliers | Durable Medical Equipment & Medical Supplies | 207X00000X | 044065 | CT | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.