Provider Demographics
NPI:1598268138
Name:ORTHO NEW ENGLAND, LLC
Entity Type:Organization
Organization Name:ORTHO NEW ENGLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-361-6650
Mailing Address - Street 1:622 BANTAM RD
Mailing Address - Street 2:
Mailing Address - City:BANTAM
Mailing Address - State:CT
Mailing Address - Zip Code:06750-1600
Mailing Address - Country:US
Mailing Address - Phone:860-361-6650
Mailing Address - Fax:860-361-6654
Practice Address - Street 1:622 BANTAM RD
Practice Address - Street 2:
Practice Address - City:BANTAM
Practice Address - State:CT
Practice Address - Zip Code:06750-1600
Practice Address - Country:US
Practice Address - Phone:860-361-6650
Practice Address - Fax:860-361-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-09
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty