Provider Demographics
NPI:1316469927
Name:ADVANCED ORTHOPEDICS NEW ENGLAND
Entity type:Organization
Organization Name:ADVANCED ORTHOPEDICS NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-728-6740
Mailing Address - Street 1:1000 ASYLUM AVE STE 2126
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1719
Mailing Address - Country:US
Mailing Address - Phone:860-728-6740
Mailing Address - Fax:
Practice Address - Street 1:893 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-2293
Practice Address - Country:US
Practice Address - Phone:860-728-6740
Practice Address - Fax:860-547-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty