Provider Demographics
NPI:1457321796
Name:VELTRI, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:VELTRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 EAST RIVER DR
Mailing Address - Street 2:5TH FL
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-7301
Mailing Address - Country:US
Mailing Address - Phone:860-282-4022
Mailing Address - Fax:860-289-0742
Practice Address - Street 1:360 TOLLAND TPKE
Practice Address - Street 2:SUITE 3-C
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1771
Practice Address - Country:US
Practice Address - Phone:860-649-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030404174400000X, 207XX0005X, 207X00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001304047Medicaid
CT001304047Medicaid
CT200000832Medicare ID - Type Unspecified