Provider Demographics
NPI:1194773382
Name:CONNECTICUT ORTHOPAEDIC AND HAND SURGERY CENTER, P.C.
Entity type:Organization
Organization Name:CONNECTICUT ORTHOPAEDIC AND HAND SURGERY CENTER, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARANGELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-456-3997
Mailing Address - Street 1:99 EAST RIVER DR.
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-4133
Mailing Address - Fax:860-289-0742
Practice Address - Street 1:5 FOUNDERS ST.
Practice Address - Street 2:SUITE 202
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226
Practice Address - Country:US
Practice Address - Phone:860-456-3997
Practice Address - Fax:860-450-7323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004395308Medicaid
CTC01093Medicare ID - Type Unspecified