EDWARD SPORL TUCKER (NPI# 1275648552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275648552 |
| Entity Type | Individual |
| Full Name | EDWARD SPORL TUCKER |
| Credential | M.D. |
| Practice Address |
67 N Main St Essex CT 06426-1074 |
| Practice Telephone | 8607671411 |
| Practice Fax Number | 8607671233 |
| Mailing Telephone | 8607671411 |
| Mailing Fax Number | 8607671233 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-07-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 013972 | CT | Other Service Providers |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
13972 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | AETNA | 507435 | 01 |
| CT | CIGNA | CIGNA | 01 |
| CT | ANTHEM BLUE CROSS | 010013972CT01 | 01 |
| CT | CONNECTICARE | 058532 | 01 |
| CT | HEALTH NET | 0V0648 | 01 |
| CT | OXFORD | P2492859 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780838458 | Edward S Tucker | Specialist | 6285 Roche Harbor Rd, Friday Harbor, WA 98250-6951 | 2008-11-07 |
| 1619584505 | Edward Austin Tucker | Nurse Practitioner | 20 Medical Center Dr Ste 300, Jasper, AL 35501-3428 | 2020-09-25 |
| 1083982417 | Edward Ross Tucker | Pharmacist | 301 W Bennett Ave, Council Bluffs, IA 51503-5179 | 2011-12-13 |
| 1568483048 | Edward Joseph Tucker | Social Worker | 385 Tremont Ave, East Orange, NJ 07018-1023 | 2006-07-21 |
| Street Address |
67 N MAIN ST |
| City | ESSEX |
| State | CT |
| Zip Code | 06426-1074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336616101 | Ventureoutherapy LLC | Marriage & Family Therapist | 67 N Main St, Essex, CT 06426-1032 | 2018-10-30 |
| 1639613870 | Katherine Mcgetrick | Marriage & Family Therapist | 67 N Main St, Essex, CT 06426-1032 | 2016-12-07 |
| 1013326818 | Leslie Strekel | Counselor | 67 N Main St, Essex, CT 06426-1032 | 2014-08-05 |
| 1801209838 | Franklin C Brown Phd LLC | Clinical Neuropsychologist | 67 N Main St, Essex, CT 06426-1032 | 2014-06-06 |
| 1821426743 | Anne Chatillon | Marriage & Family Therapist | 67 N Main St, Essex, CT 06426 | 2013-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881123867 | Art Therapy & Creative Counseling | Counselor | 80 Plains Rd Unit 1, Essex, CT 06426 | 2017-06-05 |
| 1487085593 | Catherine Mary Demers | Nurse Practitioner | 10 Wildwood Medical Center, Essex, CT 06426 | 2013-11-29 |
| 1346515723 | Anne Peterson | Counselor | 80 Plains Rd, Essex, CT 06426 | 2012-03-19 |
| 1477851731 | Diana Leigh Amara | Counselor | 80 Plains Road, Essex, CT 06426 | 2011-03-09 |
| 1609034438 | Marybeth Pytlik Ellison | Pediatrics | Sunflower Developmental Pediatrics, 11 Wildwood Medical Center, Essex, CT 06426 | 2008-05-29 |
| 1780749747 | Dana Lyn Martin | Counselor | 190 Westbrook Road, Essex Child Guidance Clinic, Essex, CT 06426 | 2006-12-27 |
| 1881768836 | Jason Christopher Andrade | Counselor | 190 Westbrock Rd, Essex, CT 06426 | 2006-11-20 |
| 1386735546 | Robert D Dwyer | Urology | 6 Wildwood Medical Center, Essex, CT 06426 | 2006-09-27 |
| 1154421071 | Sharon D Mallon | Psychologist | 251 Westbrook Rd, Essex, CT 06426 | 2006-09-22 |
| 1043319510 | Brian David Fay | Social Worker | 251 Westbrook Road, Essex, CT 06426 | 2006-09-21 |
| Find all providers in zip 06426 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255653036 | Shoreline Neurology, LLC | Psychiatry & Neurology | 180 Westbrook Rd, Building 5, Essex, CT 06426-1517 | 2010-02-22 |
| 1316956501 | Gang Gary Lian | Psychiatry & Neurology | 180 Westbrook Rd, Building 5, Essex, CT 06426-1517 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790165173 | Editha Johnson | Psychiatry & Neurology | 85 Seymour St # 825, Hartford, CT 06106-5501 | 2015-06-01 |
| 1518369925 | Maria Eugenia Garcia-ayala | Psychiatry & Neurology | 65 Memorial Rd Ste 508, West Hartford, CT 06107 | 2014-09-17 |
| 1366850521 | Mendelsohn Medical LLC | Psychiatry & Neurology | 18 Pinewood Shrs, Sherman, CT 06784-2505 | 2014-07-31 |
| 1356758387 | Idaira Aguilar Tejedor | Psychiatry & Neurology | 99 Hawley Ln Ste 1120, Stratford, CT 06614-1208 | 2014-07-22 |
| 1871908871 | Veeresh Kumar Nanjangud Shivamurthy | Psychiatry & Neurology | 1000 Asylum Ave Ste 4304, Hartford, CT 06105-1704 | 2014-06-27 |
| 1831503101 | Sarah Meira Benchaya | Psychiatry & Neurology | 80 Seymour Street #jb 604, Hartford, CT 06102 | 2014-06-16 |
| 1285048538 | Lucas Meira Benchaya | Psychiatry & Neurology | 80 Seymour St # Jb604, Hartford, CT 06102-8000 | 2014-06-15 |
| 1255742326 | Stephanie Felicia Alessi-larosa | Psychiatry & Neurology | 80 Seymour St. Jb 604, University of Connecticut/hartford Hospital, Hartford, CT 06102 | 2014-05-12 |
| 1811316250 | Leon Meytin | Psychiatry & Neurology | 280 S Main St Ste 102, Cheshire, CT 06410-3112 | 2014-04-14 |
| 1659701225 | Arthur Taub | Psychiatry & Neurology | 30 Conrad Dr, New Haven, CT 06515-2408 | 2013-11-19 |
| Find all providers with the same taxonomy | ||||
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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.