JEFFERSON RADIOLOGY, PC (NPI# 1053362350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053362350 |
Entity Type | Organization |
Organization Name | JEFFERSON RADIOLOGY, PC |
Practice Address |
704 Hebron Ave Suite 100 Glastonbury CT 06033-5020 |
Mailing Address |
111 Founders Plz Suite 400 East Hartford CT 06108-3212 |
Practice Telephone | 8606599595 |
Practice Fax Number | 8606339885 |
Mailing Telephone | 8602893375 |
Mailing Fax Number | 8607835733 |
Enumeration Date | 2006-05-12 |
Last Update Date | 2009-11-23 |
Authorized Official Name | DR. WILLIAM J GLUCKSMAN (PRESIDENT) |
Authorized Official Telephone | 8602893375 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | JEFFERSON RADIOLOGY, PC |
Parent Organization TIN |
|
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CT | CONNECTICARE | 669045 | 01 |
CT | 004000295 | 05 | |
MA | 9704507 | 05 | |
CT | OXFORD | A2516306 | 01 |
CT | CIGNA | S9999 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518158419 | Jefferson Radiology, PC | Nuclear Medicine | 23b Arts Center Ct, Avon, CT 06001 | 2007-08-06 |
1467403741 | Jefferson Radiology, PC | Radiology | 941 Farmington Ave, West Hartford, CT 06107-2203 | 2006-05-12 |
1538451042 | Jefferson Radiology, PC | Radiology | 74 Mack St, Windsor, CT 06095-2759 | 2011-05-03 |
1720316128 | Jefferson Radiology, PC | Radiology | 18 E Granby Rd, Granby, CT 06035-2201 | 2009-11-23 |
1417112962 | Jefferson Radiology, PC | Radiology | 85 Seymour St, Suite 200, Hartford, CT 06106-5501 | 2008-07-24 |
1609067503 | Jefferson Radiology, PC | Nuclear Medicine | 40 Dale Rd, Avon, CT 06001-3692 | 2007-08-06 |
1285685867 | Jefferson Radiology, PC | Radiology | 1260 Silas Deane Hwy, Suite 104, Wethersfield, CT 06109-4362 | 2006-05-16 |
1396795951 | Jefferson Radiology, PC | Nuclear Medicine | 85 Seymour St Ste 200, Hartford, CT 06106-5509 | 2006-05-12 |
1760463038 | Jefferson Radiology, PC | Radiology | 6 Northwestern Dr, Suite 102, Bloomfield, CT 06002-3463 | 2005-11-14 |
Street Address |
704 HEBRON AVE SUITE 100 |
City | GLASTONBURY |
State | CT |
Zip Code | 06033-5020 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619920592 | Consulting Ophthalmologists, P.C. | Eyewear Supplier (Equipment, not the service) | 704 Hebron Ave, Suite 200, Glastonbury, CT 06033-5020 | 2006-05-19 |
1518062850 | Evelyn Smith | Internal Medicine | 704 Hebron Ave, Suite 201, Glastonbury, CT 06033-5020 | 2006-09-13 |
1376648634 | Michael Deshaies | Internal Medicine | 704 Hebron Ave, Suite 201, Glastonbury, CT 06033-5020 | 2006-09-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477074649 | Starling Physicians, PC | Durable Medical Equipment & Medical Supplies | 289 Western Blvd, Glastonbury, CT 06033 | 2017-06-28 |
1497284897 | D&l Eyecare | Optometrist | 33 Welles Street, Glastonbury, CT 06033 | 2017-06-08 |
1730626235 | Half Full Psychiatry LLC | Clinic/Center | 39 New London Tpke Ste 230f, Glastonbury, CT 06033 | 2017-01-23 |
1285000117 | Olga A Levkina | Physician Assistant | 2928 Main St Ste 101, Glastonbury, CT 06033 | 2015-08-14 |
1619350576 | Ryan Ilg Reichelt | Dentist | 131 New London Tpke Ste 211, Glastonbury, CT 06033 | 2015-07-09 |
1316320534 | Devon Banda | Orthopaedic Surgery | The Hand Center, 195 Eastern Blvd, # 200, Glastonbury, CT 06033 | 2015-07-07 |
1881073195 | Brittney Stanley | Counselor | 122 Naubuc Ave Ste 104, Glastonbury, CT 06033 | 2015-05-20 |
1780071878 | Richard T. Risinger | Dentist | 88 Citizens Drive, Glastonbury, CT 06033 | 2015-04-16 |
1639568751 | Carol Jane Gammell | Counselor | 140 Glastonbury Boulevard, Suite 30, Glastonbury, CT 06033 | 2015-01-13 |
1407262611 | Prashant Sinha | Dentist | 2874 Main Street, Glastonbury, CT 06033 | 2014-07-08 |
Find all providers in zip 06033 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235258625 | Anthony E Baumstark | Radiology | 157 Rampart Dr, Glastonbury, CT 06033-3370 | 2007-03-28 |
1144277682 | Kenneth A Decarolis | Radiology | 667 Goodale Hill Rd, Glastonbury, CT 06033-4022 | 2006-05-30 |
1669431904 | Neal David Barkoff | Radiology | 124 Hebron Ave Ste 1b, Glastonbury, CT 06033-2066 | 2006-03-23 |
1679776835 | Mandell & Blau, Md's PC | Radiology | 124 Hebron Ave Ste 1b, Glastonbury, CT 06033-2063 | 2007-06-06 |
1376503003 | Richard Dennis Glisson | Radiology | 124 Hebron Ave Ste 1b, Glastonbury, CT 06033 | 2006-03-25 |
1942260641 | Alisa Sue Siegfeld | Radiology | 124 Hebron Ave Ste 1b, Glastonbury, CT 06033-2066 | 2006-03-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336781236 | Waterford Vascular Associates, P.C. | Radiology | 903 Hartford Tpke Unit 30, Waterford, CT 06385-4264 | 2019-10-11 |
1437700531 | Fairfield Interventional and Vascular Specialists PC | Radiology | 1 Sasco Hill Rd Ste 2, Fairfield, CT 06824-5670 | 2019-09-20 |
1356813505 | Northeast Radiology of Connecticut, LLC | Radiology | 40 Old Ridgebury Rd Ste 103, Danbury, CT 06810-5119 | 2018-12-28 |
1760964001 | Integrated Health Administrative Services, Inc. | Radiology | 1011 Hope St Ofc E, Stamford, CT 06907-2121 | 2018-09-04 |
1538682760 | Christina Prete | Radiology | 350 S Cherry St, Wallingford, CT 06492-4429 | 2017-07-19 |
1003361320 | Susan Nally | Radiology | 445 Hogan Rd, Hamden, CT 06518-1927 | 2016-08-16 |
1275987802 | Farmington Imaging Center, LLC | Radiology | 399 Farmington Ave Lowr 1, Farmington, CT 06032-1937 | 2016-04-20 |
1023498805 | Northeast Radiology of Connecticut, LLC | Radiology | 67 Sand Pit Rd Ste 101, Danbury, CT 06810-4032 | 2015-06-05 |
1538550546 | Mandell & Blau Md's PC | Radiology | 201 North Mountain Road, Plainville, CT 06062 | 2015-02-12 |
1407268543 | Jason Riley Jones | Radiology | 333 Cedar St., Room Te2, Ynhh- Dept of Radiology, New Haven, CT 06520-8042 | 2014-05-23 |
Find all providers with the same taxonomy |
City | GLASTONBURY |
Zip Code | 06033 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.