# NEUROSURGERY, ORTHOPAEDICS & SPINE SPECIALISTS, P.C.

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

## Provider details

- **NPI number:** 1700129624
- **Authorized official:** WILLIAM GODBURN (EXECUTIVE DIRECTOR - COO)
- **Authorized official phone:** (203) 573-6434

## Contact information

- **Practice address:** 690 MAIN ST S, SOUTHBURY, CT 06488-2267
- **Practice address phone:** (203) 755-6677
- **Mailing address:** 500 CHASE PKWY, WATERBURY, CT 06708-3346
- **Mailing address phone:** (203) 755-6677
- **Mailing address fax:** (203) 755-7166

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |

## Other

- **Enumeration date:** 03/28/2013
- **Last updated:** 06/18/2019