Provider Demographics
NPI:1740332162
Name:ORTHOPAEDIC ASSOCIATES OF NORTHERN CONNECTICUT, P.C.
Entity type:Organization
Organization Name:ORTHOPAEDIC ASSOCIATES OF NORTHERN CONNECTICUT, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:PASCAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-763-4041
Mailing Address - Street 1:7 ELM ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3670
Mailing Address - Country:US
Mailing Address - Phone:860-763-4041
Mailing Address - Fax:860-763-5221
Practice Address - Street 1:7 ELM ST STE 203
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3670
Practice Address - Country:US
Practice Address - Phone:860-763-4041
Practice Address - Fax:860-763-5221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT0421670001Medicare NSC