Provider Demographics
NPI:1699129957
Name:VALLEY ORTHOPAEDIC SPECIALISTS, LLC
Entity type:Organization
Organization Name:VALLEY ORTHOPAEDIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:203-734-7900
Mailing Address - Street 1:2 TRAP FALLS RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4616
Mailing Address - Country:US
Mailing Address - Phone:203-734-7900
Mailing Address - Fax:203-513-3267
Practice Address - Street 1:1275 POST RD
Practice Address - Street 2:SUITE 208
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6015
Practice Address - Country:US
Practice Address - Phone:203-734-7900
Practice Address - Fax:203-513-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033733332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02261Medicare PIN