JEFFERSON RADIOLOGY, PC (NPI# 1609067503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609067503 |
| Entity Type | Organization |
| Organization Name | JEFFERSON RADIOLOGY, PC |
| Practice Address |
40 Dale Rd Avon CT 06001-3692 |
| Mailing Address |
111 Founders Plz Suite 400 East Hartford CT 06108-3212 |
| Practice Telephone | 8606771500 |
| Practice Fax Number | 8606780382 |
| Mailing Telephone | 8602466589 |
| Mailing Fax Number | 8602916594 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |
| Authorized Official Name | MR. BOB O'DONNELL (DIRECTOR, REVENUE SERVICES) |
| Authorized Official Telephone | 8602916551 |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON RADIOLOGY, PC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CONNECTICARE | 669045 | 01 |
| CT | OXFORD | A2516306 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518158419 | Jefferson Radiology, PC | Nuclear Medicine | 23b Arts Center Ct, Avon, CT 06001 | 2007-08-06 |
| 1467403741 | Jefferson Radiology, PC | Radiology | 941 Farmington Ave, West Hartford, CT 06107-2203 | 2006-05-12 |
| 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 |
| 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 |
40 DALE RD |
| City | AVON |
| State | CT |
| Zip Code | 06001-3692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789745 | Linda Preysner | Internal Medicine | 40 Dale Rd, Suite 202, Avon, CT 06001-3692 | 2006-02-16 |
| 1851807218 | Komarow Dental PC | Clinic/Center | 40 Dale Rd, Avon, CT 06001-3692 | 2017-12-21 |
| 1811280332 | Sarah Anacleto | Counselor | 40 Dale Rd, Avon, CT 06001-3692 | 2011-05-17 |
| 1093014748 | Comprehensive Medical Group, LLC | Nurse Practitioner | 40 Dale Rd, Suite 103, Avon, CT 06001-3692 | 2011-03-21 |
| 1649573106 | Stephanie Lynn Poole | Speech-Language Pathologist | 40 Dale Rd, Avon, CT 06001-3692 | 2010-12-06 |
| 1376867580 | Nutmeg Medical Group, LLC | Internal Medicine | 40 Dale Rd, Suite 202, Avon, CT 06001-3692 | 2010-03-16 |
| 1508070343 | Kristie L Riley | Counselor | 40 Dale Rd, Avon, CT 06001-3692 | 2007-05-10 |
| 1942352794 | Lalarukh Mufti | Family Medicine | 40 Dale Rd, Suite 103, Avon, CT 06001-3692 | 2007-01-18 |
| 1962582718 | Gregory J Bombassei | Internal Medicine | 40 Dale Rd, Suite 202, Avon, CT 06001 | 2006-10-16 |
| 1063506723 | Naomi J Neuwirth | Social Worker | 40 Dale Rd, Suite 201, Avon, CT 06001 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247338 | Alledran Med LLC | Durable Medical Equipment & Medical Supplies | 47 Avonwood Road, Unit #218, Avon, CT 06001 | 2020-08-28 |
| 1265053391 | 001care Inc | In Home Supportive Care | 20 Tower Lane, Avon, CT 06001 | 2020-04-29 |
| 1649813783 | Peoplesdental, P.C. | Dentist | 20 W Avon Rd Ste 104, Avon, CT 06001 | 2019-10-22 |
| 1740822063 | I E Consulting, LLC | Home Health | 1-5 East Main Street, Avon, CT 06001 | 2019-10-09 |
| 1598324261 | Prima Labs, LLC | Orthopaedic Surgery | Dr. Alexandra 58, Kezmarok, SLOVAKIA 06001 | 2019-06-06 |
| 1194220996 | Theresa L. Hixson | Social Worker | 152 Simsbury Rd., Building 9, Avon, CT 06001 | 2018-03-26 |
| 1851809974 | Kathleen Ann Subasic | Occupational Therapist | 19 Stockbridge Dr, Avon, CT 06001 | 2018-01-11 |
| 1801254297 | Vanessa Brodie | Psychologist | 395 W Avon Rd Ste 1, Avon, CT 06001 | 2016-02-01 |
| 1346614468 | Bryan Lilley | Physical Therapist | 34 Dale Rd., 202, Avon, CT 06001 | 2015-12-01 |
| 1073947446 | Rahel K. Saroff Counseling Services LLC | Counselor | 7 Towpath Lane, Avon, CT 06001 | 2013-08-21 |
| Find all providers in zip 06001 | ||||
| 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 |
|---|---|---|---|---|
| 1336315571 | Darlene Margareta Holden | Radiology | 35836 Ithaca Dr, Avon, OH 44011-1893 | 2008-05-07 |
| 1548298326 | Herman David Coleman | Radiology | 96 Cold Spring Rd, Avon, CT 06001-4053 | 2006-06-29 |
| 1275592610 | Jay Roland Duxin | Radiology | 18 James Ct, Avon, CT 06001-2988 | 2006-03-23 |
| 1538128608 | Julie Steiner Gershon | Radiology | 20 Arch Rd., Avon, CT 06001-4202 | 2006-03-18 |
| 1114922812 | Abner S Gershon | Radiology | 21 Arch Road, Invision Medical LLC, Avon, CT 06001-0001 | 2005-06-17 |
| 1659555993 | Jason M Ford | Radiology | 1111 Ronald Reagan Pkwy, Radiology Rm 11078, Avon, IN 46123-7085 | 2007-12-21 |
| 1043370174 | Proscan Imaging of Indianapolis, LLC | Radiology | 5250 E Us Highway 36, Prestwick Pointe Suite 220, Avon, IN 46123-9199 | 2006-12-11 |
| 1164528543 | American Health Network of Indiana, LLC | Radiology | 1115 Ronald Reagan Pkwy, Suite 224, Avon, IN 46123-6910 | 2006-09-15 |
| 1144271875 | Jefferson Radiology | Radiology | 100 Simsbury Rd, Suite 101, Avon, CT 06001-3793 | 2006-05-15 |
| 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 |
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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.