Basic Information
| Provider Information | |||||||||
| NPI: | 1740583418 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTER FOR ORTHOPAEDICS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 WHITNEY AVE | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037523100 | ||||||||
| FaxNumber: | 2037529291 | ||||||||
| Practice Location | |||||||||
| Address1: | 148 EAST AVE | ||||||||
| Address2: | SUITE 2E | ||||||||
| City: | NORWALK | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068515721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037523100 | ||||||||
| FaxNumber: | 2037529291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/17/2010 | ||||||||
| LastUpdateDate: | 09/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | CAPONE | ||||||||
| AuthorizedOfficialFirstName: | MELISSA | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | CREDENTIALING/HR | ||||||||
| AuthorizedOfficialTelephone: | 2037523181 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 213E00000X | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 332B00000X | N | Suppliers | Durable Medical Equipment & Medical Supplies | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.