Provider Demographics
NPI:1801002696
Name:ORTHOPAEDIC SURGEONS PC
Entity Type:Organization
Organization Name:ORTHOPAEDIC SURGEONS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-776-9110
Mailing Address - Street 1:1481 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4305
Mailing Address - Country:US
Mailing Address - Phone:203-776-9110
Mailing Address - Fax:203-777-5879
Practice Address - Street 1:1481 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4305
Practice Address - Country:US
Practice Address - Phone:203-776-9110
Practice Address - Fax:203-777-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22197174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B38326Medicare UPIN