Provider Demographics
NPI:1790962140
Name:MICHAEL LEGEYT MD LLC
Entity Type:Organization
Organization Name:MICHAEL LEGEYT MD LLC
Other - Org Name:CONNECTICUT HAND SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LEGEYT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-223-8500
Mailing Address - Street 1:1 LIBERTY SQUARE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06050
Mailing Address - Country:US
Mailing Address - Phone:860-223-8500
Mailing Address - Fax:860-223-8512
Practice Address - Street 1:255 NORTH MAIN ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010
Practice Address - Country:US
Practice Address - Phone:860-223-8500
Practice Address - Fax:860-589-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT037666207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001376666Medicaid
G79481Medicare UPIN
CT001376666Medicaid