CANTON INTERVENTIONAL RADIOLOGIST GROUP PC (NPI# 1659922748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659922748 |
| Entity Type | Organization |
| Organization Name | CANTON INTERVENTIONAL RADIOLOGIST GROUP PC |
| Practice Address |
110 Albany Tpke Ste 209 Canton CT 06019-2549 |
| Mailing Address |
2001 Butterfield Rd Ste 300 Downers Grove IL 60515-1069 |
| Practice Telephone | 8606934060 |
| Practice Fax Number | 8606934065 |
| Mailing Telephone | 6307252700 |
| Mailing Fax Number | 8338425469 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | LORENA ESPARZA (REVENUE CYCLE MANAGER) |
| Authorized Official Telephone | 6307252764 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 202K00000X | Phlebology | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
110 ALBANY TPKE STE 209 |
| City | CANTON |
| State | CT |
| Zip Code | 06019-2549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295053502 | Connecticut Phlebology PC | Phlebology | 110 Albany Tpke Ste 209, Canton, CT 06019-2549 | 2010-05-11 |
| 1932584653 | Andrumedia Arti Field | Physician Assistant | 110 Albany Tpke Ste 209, Canton, CT 06019-2549 | 2015-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912532953 | Canton Geriatrics Pllc | Clinic/Center | 461 Cherry Brook Road, Canton, CT 06019 | 2020-03-10 |
| 1245877638 | Cara Noel Donahue | Social Worker | Farmington Valley Counseling Center, 111 Simsbury Rd, Avon, CT 06019 | 2019-12-04 |
| 1629614953 | Reformed Nutrition LLC | Dietitian, Registered | 220 Albany Turnpike, Unit 1, Canton, CT 06019 | 2019-11-21 |
| 1144607367 | Jordan Sileo Wasik | Counselor | 20 Depot St., Collinsville, CT 06019 | 2015-04-27 |
| 1578957361 | Glaser Helpers, Inc. | Home Health | 6 Wickhams Fancy, Collinsville, CT 06019 | 2015-03-19 |
| 1346686136 | Anna Sastre | Family Medicine | 117 Albany Turnpike, Canton, CT 06019 | 2013-05-20 |
| 1356698856 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 111 Albany Turnpike, Canton, CT 06019 | 2012-08-14 |
| 1881858959 | Connecticut Foot Specialists PC | Podiatrist | 259 Albany Turnpike, Suite C, Canton, CT 06019 | 2008-07-17 |
| 1073734505 | Matthew Keefe | Dentist | 191 Albany Turnpike, Canton, CT 06019 | 2007-05-01 |
| 1710092432 | Gerard Edward-zackary Bogucki | Dentist | 66 Maple Avenue, Collinsville, CT 06019 | 2006-08-20 |
| Find all providers in zip 06019 | ||||
| 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 |
|---|---|---|---|---|
| 1669458766 | Domenic A. Zambuto | Radiology | 110 Albany Tpke, 209, Canton, CT 06019-2547 | 2005-12-20 |
| 1598319386 | Madison C Schwarzentraub | Radiology | 2600 6th St Sw, Canton, OH 44710-1702 | 2019-07-30 |
| 1558523787 | Mitryan Kar | Radiology | 2600 Sixth St Sw, Radiology Associates of Canton, Inc., Canton, OH 44710-1702 | 2008-06-29 |
| 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 |
| 1417933961 | Fernando F. Illescas | Radiology | 701 Cottage Grove Rd Ste E110, Bloomfield, CT 06002-3085 | 2005-12-16 |
| 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 | ||||
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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.