Provider Demographics
NPI:1710655477
Name:NEUROSURGERY, ORTHOPAEDICS & SPINE SPECIALISTS, P.C.
Entity Type:Organization
Organization Name:NEUROSURGERY, ORTHOPAEDICS & SPINE SPECIALISTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-573-6434
Mailing Address - Street 1:NOSS
Mailing Address - Street 2:500 CHASE PARKWAY
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-755-6677
Mailing Address - Fax:
Practice Address - Street 1:THE GLASS BUILDING
Practice Address - Street 2:16 SCHOOL STREET, SUITE 210
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790
Practice Address - Country:US
Practice Address - Phone:203-755-6677
Practice Address - Fax:203-573-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty