Provider Demographics
NPI:1073331609
Name:HARTFORD ORTHOPEDIC MEDICINE, PLLC
Entity type:Organization
Organization Name:HARTFORD ORTHOPEDIC MEDICINE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:VOIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-565-5104
Mailing Address - Street 1:136 W MAIN ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1315
Mailing Address - Country:US
Mailing Address - Phone:203-565-5104
Mailing Address - Fax:860-826-4762
Practice Address - Street 1:136 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1315
Practice Address - Country:US
Practice Address - Phone:203-565-5104
Practice Address - Fax:860-826-4762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEA THREE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-02
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
No111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty