Provider Demographics
NPI:1578652335
Name:CONNECTICUT ORTHOPEDIC SERVICE, INC.
Entity Type:Organization
Organization Name:CONNECTICUT ORTHOPEDIC SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLI
Authorized Official - Middle Name:
Authorized Official - Last Name:VEITH
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:860-953-5480
Mailing Address - Street 1:942 NEW BRITAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-2228
Mailing Address - Country:US
Mailing Address - Phone:860-953-5480
Mailing Address - Fax:860-953-6742
Practice Address - Street 1:942 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06110-2228
Practice Address - Country:US
Practice Address - Phone:860-953-5480
Practice Address - Fax:860-953-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0228660001Medicare ID - Type Unspecified