Provider Demographics
NPI:1013966209
Name:CONTI ORTHOPEDIC APPLIANCE, INC.
Entity Type:Organization
Organization Name:CONTI ORTHOPEDIC APPLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONTI
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:203-457-1779
Mailing Address - Street 1:1040 ROUTE 80
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1212
Mailing Address - Country:US
Mailing Address - Phone:203-457-1779
Mailing Address - Fax:203-457-9096
Practice Address - Street 1:1040 ROUTE 80
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1212
Practice Address - Country:US
Practice Address - Phone:203-457-1779
Practice Address - Fax:203-457-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0512660001Medicare NSC