Organization
NEUROSURGERY ORTHOPAEDICS & SPINE SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID O LANE (ADMINISTRATOR)
(203) 755-6677
Entity
Organization
Contact information
Practice address
500 CHASE PKWY, WATERBURY, CT 06708-3346
(203) 755-6677
(203) 573-9182
Mailing address
500 CHASE PKWY, WATERBURY, CT 06708-3346
(203) 755-6677
(203) 573-9182
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207T00000X
Neurological Surgery Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00071
MEDICARE PTAN
—
Enumeration date
06/10/2008
Last updated
02/27/2013
Update your record
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