Provider Demographics
NPI:1699874404
Name:LITCHFIELD HILLS ORTHOPEDIC ASSOCIATES, LLP
Entity type:Organization
Organization Name:LITCHFIELD HILLS ORTHOPEDIC ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHANAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:TRYTHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-496-4160
Mailing Address - Street 1:245 ALVORD PARK RD
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-3493
Mailing Address - Country:US
Mailing Address - Phone:860-482-8539
Mailing Address - Fax:860-482-0258
Practice Address - Street 1:245 ALVORD PARK RD
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3493
Practice Address - Country:US
Practice Address - Phone:860-482-8539
Practice Address - Fax:860-482-0258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4197738Medicaid
CT6147740005Medicare NSC
CTC02547Medicare PIN