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SHORELINE ORTHOPEDICS & SPORTS MEDICINE LLC NPI 1861425597


NPI Information

NPI: 1861425597
Provider Name: SHORELINE ORTHOPEDICS & SPORTS MEDICINE, LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
12 BOKUM RD
ESSEX, CT
ZIP 06426
Phone: (860) 767-9053
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SHORELINE ORTHOPEDICS & SPORTS MEDICINE, LLC is an orthopaedic surgery in Essex, CT. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. SHORELINE ORTHOPEDICS & SPORTS MEDICINE, LLC NPI is 1861425597. The provider is registered as an organization entity type.

The provider's business location address is:

12 BOKUM RD
ESSEX, CT
ZIP 06426-500
Phone: (860) 767-9053
Fax: (860) 767-1146

The provider's authorized official is Martin Jeffrey White .
The authorized official title is Physician Partner and has the following contact phone number (860) 767-9053.

The enumeration date for this NPI number is 7/8/2006 and was last updated on 12/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies027273CONNECTICUTNo
2207X00000XOrthopaedic SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004246824MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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