JEFFERSON RADIOLOGY, PC


Address: 704 Hebron Ave, Suite 100, Glastonbury, CT 06033-5020
Phone: 8606599595

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
CT CONNECTICARE 669045 01
CT 004000295 05
MA 9704507 05
CT OXFORD A2516306 01
CT CIGNA S9999 01

Other Provider IDs and Locations

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

Office Location

Street Address 704 HEBRON AVE
SUITE 100
City GLASTONBURY
State CT
Zip Code 06033-5020

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

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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
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Competitor

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City GLASTONBURY
Zip Code 06033

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Dataset Information

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.

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