# COASTAL ORTHOPAEDICS, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COASTAL ORTHOPAEDICS, PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780021725
- **Legal business name:** COASTAL ORTHOPAEDICS, PC
- **Authorized official:** RICHARD C LYON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (203) 845-2200

## Contact information

- **Practice address:** 30 EAST AVE, NEW CANAAN, CT 06840-5516
- **Practice address phone:** (203) 845-2200
- **Practice address fax:** (203) 847-1940
- **Mailing address:** 761 MAIN AVE, SUITE 300, NORWALK, CT 06851-1080
- **Mailing address phone:** (203) 845-2200
- **Mailing address fax:** (203) 847-1940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | CT | Yes |
| 207XP3100X | Pediatric Orthopaedic Surgery Physician | — | CT | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | CT | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | CT | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | CT | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | CT | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | CT | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | CT | — |

## Other

- **Enumeration date:** 05/31/2013
- **Last updated:** 09/15/2014