DR. STANLEY JOHN DEZJOT (NPI# 1669583423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669583423 |
| Entity Type | Individual |
| Full Name | DR. STANLEY JOHN DEZJOT |
| Credential | D.C. |
| Practice Address |
108 New London Tpke Norwich CT 06360-2645 |
| Mailing Address |
Po Box 279 East Lyme CT 06333-0279 |
| Practice Telephone | 8608868007 |
| Practice Fax Number | 8608869545 |
| Mailing Telephone | 8608868007 |
| Mailing Fax Number | 8608869545 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
1014 | CT | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 4135944 | 05 |
| Street Address |
108 NEW LONDON TPKE |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588653596 | Kathleen Bonin | Nurse Practitioner | 108 New London Tpke, Norwich, CT 06360-2645 | 2005-10-21 |
| 1023479375 | Jeigh Hayes Health and Wellness | Counselor | 108 New London Tpke, Office 3, Suite A, Norwich, CT 06360-2645 | 2016-03-15 |
| 1891130597 | Kelly Jaziri | Psychiatry & Neurology | 108 New London Tpke, Norwich, CT 06360 | 2013-05-08 |
| 1467600692 | William Scott Cherry | Social Worker | 108 New London Tpke, Norwich Psychiatric Center, Norwich, CT 06360 | 2008-08-29 |
| 1073784369 | Faith Marrion | Social Worker | 108 New London Tpke, Norwich, CT 06360-2645 | 2008-03-14 |
| 1629282181 | Liliana Galan Md LLC | Internal Medicine | 108 New London Tpke, Norwich, CT 06360-2645 | 2007-05-10 |
| 1518003680 | Norwich Psychiatric Center | Counselor | 108 New London Tpke, Norwich, CT 06360-2645 | 2007-01-29 |
| 1669518635 | Mary E. Kennedy | Nurse Practitioner | 108 New London Tpke, Norwich, CT 06360-2645 | 2007-01-29 |
| 1235275256 | Janine D. Sylvia | Counselor | 108 New London Tpke, Norwich, CT 06360-2645 | 2007-01-29 |
| 1588700538 | Eileen M. Moore | Nurse Practitioner | 108 New London Tpke, Norwich, CT 06360-2645 | 2007-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
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| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275995441 | Daly Method LLC | Chiropractor | 272 Post Rd E, Westport, CT 06880-3614 | 2016-03-25 |
| 1760866719 | Loving Hands Chiropractic LLC | Chiropractor | 1733 Storrs Rd Ste 11, Storrs, CT 06268 | 2015-07-18 |
| 1356746945 | Nodine Chiropractic, LLC | Chiropractor | 945 New Britain Ave, 1st Floor, West Hartford, CT 06110-2230 | 2014-10-26 |
| 1023348224 | Ov Enterprises LLC | Chiropractor | 165 River Rd, Willington, CT 06279-1655 | 2010-01-11 |
| 1942432166 | Dr. Brett M. Carr, LLC | Chiropractor | 1700 Post Rd Ste C16, Fairfield, CT 06824-5726 | 2009-08-21 |
| 1285763300 | Leonard Bruce Fox | Chiropractor | 992 Danbury Rd, Georgetown, CT 06829 | 2007-03-05 |
| 1730215872 | Peter J. Lawler | Chiropractor | 780 Chestnut Hill Rd, Glastonbury, CT 06033-4114 | 2007-02-25 |
| 1669529962 | Steven Joseph O'donnell | Chiropractor | 74 S Broad St, Meriden, CT 06450-6545 | 2007-01-05 |
| 1093808685 | Ralph Anthony Santora | Chiropractor | 97 East St, Bethlehem, CT 06751-1804 | 2006-10-02 |
| 1033218862 | Lisa Suzanne Clyne | Chiropractor | 1300 Post Rd E, Westport, CT 06880-5537 | 2006-09-21 |
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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.