Provider Demographics
NPI:1992908032
Name:ORTHOPEDICHEALTH LLC
Entity type:Organization
Organization Name:ORTHOPEDICHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEDD
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-877-5522
Mailing Address - Street 1:849 BOSTON POST ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3551
Mailing Address - Country:US
Mailing Address - Phone:203-877-5522
Mailing Address - Fax:203-877-2108
Practice Address - Street 1:849 BOSTON POST ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3551
Practice Address - Country:US
Practice Address - Phone:203-877-5522
Practice Address - Fax:203-877-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC03366OtherMEDICARE-UNSPECIFIED
CT6339470001Medicare NSC