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SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC NPI 1114979614


NPI Information

NPI: 1114979614
Provider Name: SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
495 ROUTE 184
SUITE 300
GROTON, CT
ZIP 06340
Phone: (860) 449-1413
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SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC is an orthopaedic surgery in Groton, 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. SEACOAST ORTHOPEDIC SURGERY & SPORTS MEDICINE LLC NPI is 1114979614. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

495 ROUTE 184
SUITE 300
GROTON, CT
ZIP 06340
Phone: (860) 449-1413
Fax: (860) 449-0390

The provider's authorized official is Steven B Carlow .
The authorized official title is Doctor and has the following contact phone number (860) 449-1413.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 1/23/2013.


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
1207X00000XOrthopaedic 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
1047870OTHERCONNECTICUTLICENSE NUMBER
2H79818MEDICARE UPIN
3D02606MEDICARE UPIN
4001409756MEDICAIDCONNECTICUT
5040975OTHERCONNECTICUTLICENSE NUMBER
6004237146MEDICAIDCONNECTICUT
7D02481MEDICARE UPIN
8001272939MEDICAIDCONNECTICUT
9001253582MEDICAIDCONNECTICUT

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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