Organization
ORTHOPAEDIC ASSOCIATES OF NORTHEASTERN CONNECTICUT, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN WARE GAGNON (OFFICE MANAGER)
(860) 928-7939
Entity
Organization
Contact information
Practice address
255 POMFRET ST., PUTNAM, CT 06260
(860) 928-7939
(860) 928-4587
Mailing address
PO BOX 456, PUTNAM, CT 06260-0456
(860) 928-7939
(860) 928-4587
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
014465
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010014465CT01
BLUE CROSS BLUE SHIELD
CT
01
—
D100000062
MEDICARE PTAN
CT
Enumeration date
10/04/2007
Last updated
03/03/2009
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