PROSPECT DIAGNOSTIC IMAGING (NPI# 1154343739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154343739 |
| Entity Type | Organization |
| Organization Name | PROSPECT DIAGNOSTIC IMAGING |
| Practice Address |
166 Waterbury Road Rte 69 Prospect CT 06712 |
| Mailing Address |
385 Main St S Union Square Bldg #1 C/o Nvra Southbury CT 06488-4240 |
| Practice Telephone | 2037587700 |
| Mailing Telephone | 2032647999 |
| Mailing Fax Number | 2032647477 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2013-06-06 |
| Authorized Official Name | DR. ROBERT GUMBARDO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2032647999 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | NAUGATUCK VALLEY RADIOLOGICAL ASSOC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities | ||
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004221363 | 05 |
| Street Address |
166 WATERBURY ROAD RTE 69 |
| City | PROSPECT |
| State | CT |
| Zip Code | 06712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033167804 | Greater Waterbury Primary Care Assoc | Internal Medicine | 166 Waterbury Road, Ste 300, Prospect, CT 06712 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679746440 | Debra Anne Hudobenko | Social Worker | 40 Union City Rd Ste 2b, Prospect, CT 06712 | 2008-04-11 |
| 1831230739 | Jeffrey Paul Dalessandro | Pharmacist | Ezpharm Pharmacy, 166 Waterbury Rd, Prospect, CT 06712 | 2007-02-12 |
| 1497817464 | Kenneth Robert Capozzi | Dentist | 2 Summit Rd, Prospect, CT 06712 | 2006-12-15 |
| 1821160961 | Jeremy August | Psychiatry & Neurology | 39a Waterbury Road, Prospect, CT 06712 | 2006-11-14 |
| 1831260850 | Thomas J Deluca | Optometrist | 67 Waterbury Rd, Prospect, CT 06712 | 2006-11-13 |
| 1578648606 | Renika N Mcleod-labissiere | Family Medicine | 115 Waterbury Road, Prospect, CT 06712 | 2006-10-26 |
| 1750461836 | Eye Care Associates | Optometrist | 67 Waterbury Road, Prospect, CT 06712 | 2006-10-16 |
| 1124123948 | Carmelita Viega Rifkin | Physical Therapist | 93 Waterbury Rd, Prospect, CT 06712 | 2006-09-14 |
| 1730141730 | Amy Y Tso | Ophthalmology | 166 Waterbury Rd., Suite 201, Prospect, CT 06712 | 2006-04-05 |
| 1124680269 | Nabeel Qureshi | Internal Medicine | 73 Waterbury Road, Suite 1, Prospect, CT 06712 | 2019-06-28 |
| Find all providers in zip 06712 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700330883 | Prestige Diagnostic Imaging LLC | Clinic/Center | 60 Yowago Ave, Branford, CT 06405-5543 | 2016-08-07 |
| 1093138828 | Connecticut Womens Imaging | Clinic/Center | 105 Newtown Rd Ste C, Danbury, CT 06810-4194 | 2014-01-30 |
| 1699056135 | Southern Connecticut Imaging Centers, LLC | Clinic/Center | 2543 Dixwell Ave Ste 100, Hamden, CT 06514-1860 | 2011-08-29 |
| 1740387182 | Western Connecticut Health Network Affiliates, Inc. | Clinic/Center | 901 Ethan Allen Highway, Suite 104, Ridgefield, CT 06877 | 2006-09-20 |
| 1043232622 | Naugatuck Diagnostic Imaging | Clinic/Center | 305 Church Street, Naugatuck, CT 06770 | 2006-07-24 |
| 1639113319 | Echn Wellness Services, Inc. | Clinic/Center | 2800 Tamarack Drive, Suite 001, South Windsor, CT 06074 | 2006-06-15 |
| 1023062502 | Western Connecticut Health Network Affiliates, Inc. | Clinic/Center | 20 Germantown Road, Danbury, CT 06810 | 2006-05-20 |
| 1154810828 | Sanitas of Connecticut LLC | Clinic/Center | 4551 Main St, Bridgeport, CT 06606-1818 | 2018-05-08 |
| 1407234149 | Clinisanitas, PC | Clinic/Center | 100 Boston Post Rd, Orange, CT 06477-3233 | 2015-05-14 |
| 1821402306 | New York Society for The Relief of The Ruptured and Crippled | Clinic/Center | 1 Blachley Rd, Hss Stamford Outpatient Center, Stamford, CT 06902-0002 | 2014-06-12 |
| 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.