DR. DANA ROBERT LACEY (NPI# 1952372971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952372971 |
Entity Type | Individual |
Full Name | DR. DANA ROBERT LACEY |
Credential | M.D. |
Practice Address |
1 Wahoo Ave Groton CT 06349-2324 |
Practice Telephone | 8606942435 |
Mailing Telephone | 8606942435 |
Enumeration Date | 2006-01-28 |
Last Update Date | 2020-10-14 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085B0100X |
Radiology Specialization: Body Imaging |
9901 | HI | Allopathic & Osteopathic Physicians |
Y | 2085B0100X |
Radiology Specialization: Body Imaging |
28293 | OK | Allopathic & Osteopathic Physicians |
N | 2085B0100X |
Radiology Specialization: Body Imaging |
G82305 | CA | Allopathic & Osteopathic Physicians |
Street Address |
1 WAHOO AVE |
City | GROTON |
State | CT |
Zip Code | 06349-2324 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043207004 | Matthew Braden Burns Miller | Dentist | 1 Wahoo Ave, Groton, CT 06349 | 2005-10-04 |
1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
1770112708 | Amanda Kathleen Dobyns | Occupational Therapist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-04-02 |
1831732825 | Cody Clark | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-10-22 |
1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
1699335372 | Cynthia Daigneault | Counselor | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-06-16 |
1942868211 | Cameron Anson Martin | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340 | 2019-06-03 |
1104386903 | Zena Sabath | General Practice | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-03-20 |
1538636527 | Winston Eugene Young | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-27 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
1588127575 | Morgan Ross Jones | Student in an Organized Health Care Education/Training Program | Bx 159 Navsubase Nlon, Groton, CT 06349 | 2019-04-08 |
1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
1013264423 | Dennis Buenaventura Custodio | Military Health Care Provider | 69 Trout Ave, Naval Undersea Medical Institute, Groton, CT 06349 | 2012-08-06 |
1609013549 | Nicolas David Mendoza | Military Health Care Provider | Uss Hawaii (ssn 776), Fpo, AE 06349 | 2009-01-14 |
1881843084 | Mark Francis Jarvis | Military Health Care Provider | Nssc Nlon, Bldg 76, Groton, CT 06349 | 2008-09-11 |
1780882738 | Michael Nutt | Military Health Care Provider | Bldg 517 Taugtog Ave, Navsubscol, Groton, CT 06349 | 2007-07-10 |
1497811343 | Keith Benjamin Hoekman | Nurse Practitioner | 1 Wahoo Dr, Groton, CT 06349 | 2006-12-28 |
1881604163 | Christina E Toufexis | Pediatrics | 1 Wahoo Drive, Groton, CT 06349 | 2006-08-09 |
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Taxonomy Code | 2085B0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Body Imaging |
A Radiology doctor of Osteopathy that specializes in Body Imaging. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487815502 | Marcia Menezes Walker | Radiology | 5738 Main St, Trumbull, CT 06611-3136 | 2008-06-20 |
1114121423 | Ashutosh Pathak | Radiology | Veteran Affairs Medical Center, 950 Campell Avenue, West Haven, CT 06516 | 2007-06-12 |
1528170198 | Yvette D. Bailey | Radiology | 58 High Gate Dr, Avon, CT 06001-4111 | 2006-08-31 |
1659393247 | Paolo Olcese | Radiology | 385 Main St S, C/o Nvra Imaging Network, Union Square, Southbury, CT 06488-4240 | 2006-07-24 |
1033130729 | Marie Yanez | Radiology | 25 Glen Ridge Rd # 31155, Greenwich, CT 06831-3641 | 2006-07-21 |
1205495850 | Radiology Associates of Hartford PC | Radiology | 673 Cottage Grove Rd, Bloomfield, CT 06002-3033 | 2019-06-07 |
1215311386 | Jia Rong Chong | Radiology | 333 Cedar Street, New Haven, CT 06520 | 2015-07-17 |
1518269091 | Connecticut Valley Radiology, PC | Radiology | 19 Woodland St, Suite 15, Hartford, CT 06105-2372 | 2010-12-03 |
1801100367 | Swapnil S Bagade | Radiology | 1000 Asylum Ave, Suite 3201e, Hartford, CT 06105-1770 | 2010-07-27 |
1689835688 | Radiology Associates of Hartford PC | Radiology | 1000 Asylum Ave, Suite 3201e, Hartford, CT 06105-1770 | 2008-06-23 |
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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.