Provider Demographics
NPI:1033224498
Name:NEW MILFORD SPINE AND ORTHOPEDIC INSTITUTE, PC
Entity Type:Organization
Organization Name:NEW MILFORD SPINE AND ORTHOPEDIC INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-567-1011
Mailing Address - Street 1:PO BOX 1802
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-1802
Mailing Address - Country:US
Mailing Address - Phone:860-567-1011
Mailing Address - Fax:860-350-2224
Practice Address - Street 1:9 EAST ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3601
Practice Address - Country:US
Practice Address - Phone:860-567-1011
Practice Address - Fax:860-350-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C02625Medicare ID - Type Unspecified