Provider Demographics
NPI:1568501864
Name:ORTHOCONNECTICUT, PC
Entity type:Organization
Organization Name:ORTHOCONNECTICUT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:GIUSEPPE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGIOVANNI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-797-1500
Mailing Address - Street 1:226 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6814
Mailing Address - Country:US
Mailing Address - Phone:203-797-1500
Mailing Address - Fax:203-791-0495
Practice Address - Street 1:900 MAIN ST S
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-4237
Practice Address - Country:US
Practice Address - Phone:203-797-1500
Practice Address - Fax:475-289-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0423250002Medicare NSC