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Contact Information

EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC
2800 TAMARACK AVE
SUITE 104
SOUTH WINDSOR, CT06074
 Phone: 860-648-0814
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC

NPI # 1679950950
LBN Legal business name EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC
Authorized official CHERYL FLANAGAN - (CREDENTIALER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/06/2015
Last updated 05/06/2015 - About 11 years ago
Identifiers
CT License # 038984
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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