Basic Information
| Provider Information | |||||||||
| NPI: | 1710655477 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEUROSURGERY, ORTHOPAEDICS & SPINE SPECIALISTS, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | NOSS | ||||||||
| Address2: | 500 CHASE PARKWAY | ||||||||
| City: | WATERBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037556677 | ||||||||
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| Practice Location | |||||||||
| Address1: | THE GLASS BUILDING | ||||||||
| Address2: | 16 SCHOOL STREET, SUITE 210 | ||||||||
| City: | TORRINGTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037556677 | ||||||||
| FaxNumber: | 2035731272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2021 | ||||||||
| LastUpdateDate: | 08/30/2021 | ||||||||
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| AuthorizedOfficialLastName: | SIMAO | ||||||||
| AuthorizedOfficialFirstName: | TAMMIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO/EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2035736434 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 08/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | N | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor | 207T00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.