Provider Demographics
NPI:1073996377
Name:ORTHOPAEDIC ASSOCIATES OF STAMFORD PC
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF STAMFORD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-325-4087
Mailing Address - Street 1:P.O.BOX 848623
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284
Mailing Address - Country:US
Mailing Address - Phone:203-325-4087
Mailing Address - Fax:203-504-6000
Practice Address - Street 1:1281 E MAIN ST
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3544
Practice Address - Country:US
Practice Address - Phone:203-325-4087
Practice Address - Fax:203-504-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty