# CROSSROADS ORTHOPAEDIC SUBSPECIALISTS LLC

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

## Provider details

- **NPI number:** 1669492583
- **Authorized official:** MR. DAVID STAHELSKI (PRACTICE ADMINISTRATER)
- **Authorized official phone:** (860) 442-5361

## Contact information

- **Practice address:** 196 PARKWAY S STE 201, WATERFORD, CT 06385-1234
- **Practice address phone:** (860) 442-5361
- **Practice address fax:** (860) 437-0318
- **Mailing address:** 196 PARKWAY S STE 201, WATERFORD, CT 06385-1234
- **Mailing address phone:** (860) 442-5361
- **Mailing address fax:** (860) 437-0318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 06/24/2013