Provider Demographics
NPI:1275035610
Name:ORTHOCONNECTICUT, PC
Entity Type:Organization
Organization Name:ORTHOCONNECTICUT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:FRYDRYCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-845-2995
Mailing Address - Street 1:2 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6268
Mailing Address - Country:US
Mailing Address - Phone:203-797-1500
Mailing Address - Fax:
Practice Address - Street 1:338 BANTAM RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3318
Practice Address - Country:US
Practice Address - Phone:203-797-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOCONNECTICUT, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty