Provider Demographics
NPI:1669995163
Name:ORTHOCONNECTICUT, PC
Entity type:Organization
Organization Name:ORTHOCONNECTICUT, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-845-2200
Mailing Address - Street 1:323 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4810
Mailing Address - Country:US
Mailing Address - Phone:203-845-2200
Mailing Address - Fax:203-847-1940
Practice Address - Street 1:323 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4810
Practice Address - Country:US
Practice Address - Phone:203-845-2200
Practice Address - Fax:203-847-1940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOCONNECTICUT, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC00521OtherMEDICARE