JEFFERSON RADIOLOGY, PC (NPI# 1467403741) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467403741 |
| Entity Type | Organization |
| Organization Name | JEFFERSON RADIOLOGY, PC |
| Practice Address |
941 Farmington Ave West Hartford CT 06107-2203 |
| Mailing Address |
111 Founders Plz Suite 400 East Hartford CT 06108-3212 |
| Practice Telephone | 8602311900 |
| Practice Fax Number | 8602366153 |
| Mailing Telephone | 8605282080 |
| Mailing Fax Number | 8602916594 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-09 |
| Authorized Official Name | MR. ROBERT O'DONNELL (DIRECTOR, REVENUE SERVICES) |
| Authorized Official Telephone | 8602916551 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CONNECTICARE | 669045 | 01 |
| CT | WELLCARE/PREFERRED ONE | NY108137 | 01 |
| MA | 9704507 | 05 | |
| CT | OXFORD | A2516303 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518158419 | Jefferson Radiology, PC | Nuclear Medicine | 23b Arts Center Ct, Avon, CT 06001 | 2007-08-06 |
| 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 |
| 1053362350 | Jefferson Radiology, PC | Nuclear Medicine | 704 Hebron Ave, Suite 100, Glastonbury, CT 06033-5020 | 2006-05-12 |
| 1760463038 | Jefferson Radiology, PC | Radiology | 6 Northwestern Dr, Suite 102, Bloomfield, CT 06002-3463 | 2005-11-14 |
| Street Address |
941 FARMINGTON AVE |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06107-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538783659 | Briana Deslauriers | Audiologist | Solinsky Hearing Center, 1013 Farmington Avenue, West Hartford, CT 06107 | 2020-06-04 |
| 1750851366 | Candyce Yvonne Scott | Counselor | 61 S Main St Ste 310, West Hartford, CT 06107 | 2018-11-27 |
| 1124524798 | Image of Light Mental Health Services, LLC | Nurse Practitioner | 45 S Main St Ste 70, West Hartford, CT 06107 | 2018-04-03 |
| 1235632498 | Leila Fussell | Student in an Organized Health Care Education/Training Program | 175 Garfield Rd, West Hartford, CT 06107 | 2018-03-14 |
| 1568818169 | Gail Southard Canzano | Psychologist | 81 S. Main St, West Hartford, CT 06107 | 2016-05-12 |
| 1922470939 | Optimal Wellness of West Hartford | Family Medicine | 1001 Farmington Ave., West Hartford, CT 06107 | 2015-10-29 |
| 1518369925 | Maria Eugenia Garcia-ayala | Psychiatry & Neurology | 65 Memorial Rd Ste 508, West Hartford, CT 06107 | 2014-09-17 |
| 1376884981 | Robert Moss | Pediatrics | 174 Wood Pond Road, West Hartford, CT 06107 | 2013-03-06 |
| 1659630960 | Michael John Grille | Anesthesiology | 65 Memorial Rd #435, Hartford Hospital Pain Treatment Center, West Hartford, CT 06107 | 2012-05-07 |
| 1518268010 | Parsons Health Co. Inc | Legal Medicine | 61 So Main Street, Suite 202, West Hartford, CT 06107 | 2010-11-15 |
| Find all providers in zip 06107 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841300589 | Mandell & Blau, Md's PC | Radiology | 65 Memorial Rd Ste 510, West Hartford, CT 06107-4226 | 2006-08-30 |
| 1548350267 | Mandell & Blau, Md's PC | Radiology | 65 Memorial Rd, Suite 510, West Hartford, CT 06107-2434 | 2006-10-13 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | WEST HARTFORD |
| Zip Code | 06107 |
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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.