Provider Demographics
NPI:1922154905
Name:ORTHOPAEDIC ASSOCIATES OF STAMFORD PC
Entity Type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF STAMFORD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNOR-BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-325-4087
Mailing Address - Street 1:PO BOX 848623
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8623
Mailing Address - Country:US
Mailing Address - Phone:203-325-4087
Mailing Address - Fax:203-359-9941
Practice Address - Street 1:90 MORGAN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5436
Practice Address - Country:US
Practice Address - Phone:203-325-4087
Practice Address - Fax:203-359-9941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCO1839Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CT0765240001Medicare NSC