# COASTAL ORTHOPAEDICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104024728
- **Authorized official:** DONNA FRYDRYCH (EXECUTIVE ASSISTANT)
- **Authorized official phone:** (203) 845-2995

## Contact information

- **Practice address:** 36 OLD KINGS HWY SOUTH, DARIEN, CT 06880
- **Practice address phone:** (203) 845-2995
- **Practice address fax:** (203) 847-1940
- **Mailing address:** 761 MAIN AVE, SUITE 115, NORWALK, CT 06851-1080
- **Mailing address phone:** (203) 845-2995
- **Mailing address fax:** (203) 847-1940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician | — | NULL | — |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician | — | — | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | — | NULL | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | — | — | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | NULL | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 225XH1200X | Hand Occupational Therapist | — | NULL | — |
| 225XH1200X | Hand Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 07/05/2007
- **Last updated:** 09/15/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | C02816 | MEDICARE ID | CT |