FERNANDO F. ILLESCAS (NPI# 1417933961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417933961 |
| Entity Type | Individual |
| Full Name | FERNANDO F. ILLESCAS |
| Credential | M.D. |
| Practice Address |
701 Cottage Grove Rd Ste E110 Bloomfield CT 06002-3085 |
| Practice Telephone | 8602652529 |
| Practice Fax Number | 8604639562 |
| Mailing Telephone | 8605190620 |
| Mailing Fax Number | 8609042463 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2018-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
031371 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 1417933961 | 05 | |
| CT | OXFORD | A2516306 | 01 |
| CT | 001313717 | 05 | |
| CT | ANTHEM BC/BS | 010031371CT01 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 113 Elm St Ste 301, Enfield, CT 060823739 | 8602652529 | 8602653551 |
| Street Address |
701 COTTAGE GROVE RD STE E110 |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-3085 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053347641 | Morphe'md | Radiology | 701 Cottage Grove Rd, Building D210, Bloomfield, CT 06002-3080 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083859649 | Thomas V Divinagracia | Radiology | 85 Seymour St., Suite 409, Hartford, CT 06106 | 2008-12-11 |
| 1336176270 | Daniel Jay Kase | Radiology | 57 Commercial Blvd, Torrington, CT 06790-3097 | 2006-06-27 |
| 1184686933 | Bryan Thomas Suchecki | Radiology | 65 Douglas Rd, Glastonbury, CT 06033-2219 | 2006-04-05 |
| 1669458766 | Domenic A. Zambuto | Radiology | 110 Albany Tpke, 209, Canton, CT 06019-2547 | 2005-12-20 |
| 1700494887 | Advanced Radiology Partners LLC | Radiology | 15 Corporate Dr, Trumbull, CT 06611-1351 | 2020-07-15 |
| 1417574708 | K&h Medical Ct Pllc | Radiology | 160 West Street, Builing 1 Suite 7, Cromwell, CT 06416 | 2020-07-02 |
| 1174168926 | Vinay Madan, Md, LLC | Radiology | 35 Danbury Rd, Wilton, CT 06897-4428 | 2019-11-14 |
| 1639739634 | Vein Centers, LLC | Radiology | 23 Cedar St, New Britain, CT 06052-1301 | 2019-06-20 |
| 1417361627 | James Gardner | Radiology | 20 York St, New Haven, CT 06510-3220 | 2014-06-16 |
| 1033553508 | Pallavi Nadendla | Radiology | 111 Founders Plz Ste 400, East Hartford, CT 06108 | 2013-04-26 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMFIELD |
| Zip Code | 06002 |
Please comment or provide details below to improve the information on FERNANDO F. ILLESCAS.
| 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.