Provider Demographics
NPI:1508941584
Name:SPINELLA ORTHOPAEDIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SPINELLA ORTHOPAEDIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPINELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-246-2541
Mailing Address - Street 1:1000 ASYLUM AVE
Mailing Address - Street 2:2106
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1770
Mailing Address - Country:US
Mailing Address - Phone:860-246-2541
Mailing Address - Fax:860-247-5213
Practice Address - Street 1:1000 ASYLUM AVE
Practice Address - Street 2:2106
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1719
Practice Address - Country:US
Practice Address - Phone:860-246-2541
Practice Address - Fax:860-247-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021390174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38468Medicare UPIN
CT200000221Medicare ID - Type Unspecified