JEFFERSON RADIOLOGY, PC (NPI# 1760463038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760463038 |
| Entity Type | Organization |
| Organization Name | JEFFERSON RADIOLOGY, PC |
| Practice Address |
6 Northwestern Dr Suite 102 Bloomfield CT 06002-3463 |
| Mailing Address |
111 Founders Plz Suite 400 East Hartford CT 06108-3212 |
| Practice Telephone | 8602893375 |
| Practice Fax Number | 8607835733 |
| Mailing Telephone | 8602893375 |
| Mailing Fax Number | 8607835733 |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2009-11-23 |
| Authorized Official Name | WILLIAM J GLUCKSMAN (PRESIDENT) |
| Authorized Official Telephone | 8602893375 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | JEFFERSON RADIOLOGY, PC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | OXFORD | A2516306 | 01 |
| CT | CIGNA | S9999 | 01 |
| CT | 004000295 | 05 | |
| CT | CONNECTICARE | 669045 | 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 |
| 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 |
| Street Address |
6 NORTHWESTERN DR SUITE 102 |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053373431 | Saumitra R Banerjee | Colon & Rectal Surgery | 6 Northwestern Dr, Suite # 305, Bloomfield, CT 06002-3463 | 2006-04-03 |
| 1043596646 | Maureen Elizabeth Fearon | Nurse Practitioner | 6 Northwestern Dr, Suite 303, Bloomfield, CT 06002-3463 | 2011-10-26 |
| 1508099243 | Susan Silverman Neagle | Nurse Practitioner | 6 Northwestern Dr, Suite 201, Bloomfield, CT 06002-3463 | 2009-08-28 |
| 1205063849 | Daniel James Mullins | Colon & Rectal Surgery | 6 Northwestern Dr, Bloomfield, CT 06002-3463 | 2009-06-21 |
| 1629216569 | Nirupa Rachel Sekaran | Registered Nurse | 6 Northwestern Dr, Bloomfield, CT 06002-3463 | 2009-01-30 |
| 1922266436 | Eric Michael Bezler | Pediatrics | 6 Northwestern Dr, Suite 101, Bloomfield, CT 06002-3463 | 2008-05-30 |
| 1124175070 | Robert T Lewis | Surgery | 6 Northwestern Dr, Suite 305, Bloomfield, CT 06002-3463 | 2007-01-04 |
| 1336246925 | Kevin J Connolly | Psychologist | 6 Northwestern Dr, Suite 306, Bloomfield, CT 06002-3463 | 2006-09-17 |
| 1700980323 | Richard Slater | Internal Medicine | 6 Northwestern Dr, Suite 302, Bloomfield, CT 06002-3463 | 2006-09-12 |
| 1386748994 | Paul A Shapiro | Internal Medicine | 6 Northwestern Dr, Suite 302, Bloomfield, CT 06002-3463 | 2006-09-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558908897 | Duncaster, Inc. | Clinic/Center | 30 Loeffler Rd., Bloomfield, CT 06002 | 2019-12-05 |
| 1104467919 | Caroline Suzanne Carey Oesch | Counselor | 71 West Dudley St, Bloomfield, CT 06002 | 2019-10-02 |
| 1679047534 | Inspire Me, LLC | Counselor | 1-2 Camelot Drive, Bloomfield, CT 06002 | 2019-01-14 |
| 1508348947 | Rebecca Perry | Student in an Organized Health Care Education/Training Program | 693 Bloomfield Avenue, Bloomfield, CT 06002 | 2018-09-01 |
| 1760996946 | Monique Edwards | Social Worker | 705 New Briatin Ave, Chd, Bloomfield, CT 06002 | 2017-11-27 |
| 1225564412 | Merva E Dixon | Nurse Practitioner | 38 Hill Farm Rd, Bloomfield, CT 06002 | 2017-05-07 |
| 1538602610 | Jaime Acevedo | Counselor | 571 Bloomfield Ave, Bloomfield, CT 06002 | 2016-11-22 |
| 1669835138 | Jacob Badura | Pharmacist | 799-824 Park Ave, Bloomfield, CT 06002 | 2016-04-01 |
| 1316283328 | Julie Jason Farrelly | Counselor | 45 Wintonbury Ave Ste 102, Bloomfield, CT 06002 | 2012-12-19 |
| 1184915860 | Rachel Benedetto Scott | Surgery | 6 Northwestern Drive, Suite 305, Bloomfield, CT 06002 | 2011-04-28 |
| Find all providers in zip 06002 | ||||
| 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. |
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|---|---|---|---|---|
| 1336693993 | Riverside Radiology Medical Group, Inc | Radiology | 3309 Squirrel Rd, Bloomfield, MI 48304-2456 | 2016-08-11 |
| 1639224058 | Radiology Associates of Ottumwa, P.C. | Radiology | 507 N Madison St, Bloomfield, IA 52537-1271 | 2007-01-24 |
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|---|---|---|---|---|
| 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 | BLOOMFIELD |
| Zip Code | 06002 |
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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.