Active NPI
Joseph E Struckus, PH.D.
- Clinical Neuropsychologist
- New Preston, CT
National Provider Identifier
1144305079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 001640
- Practice address
- 10 Main Street
New Preston, CT 06777-2219 - Phone
- (860) 868-9000
- Fax
- (860) 868-0055
- NPI assigned
- Oct 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 001640 | CT | Primary |
Addresses
Primary practice location
10 Main Street
New Preston, CT 06777-2219
Mailing address
10 Main Street
P.O. Box 2219
New Preston, CT 06777-2219
Phone (860) 868-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001640 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144305079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MAIN STREET",
"address_2": "P.O. BOX 2219",
"city": "NEW PRESTON",
"state": "CT",
"postal_code": "067772219",
"telephone_number": "860-868-9000",
"fax_number": "860-868-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MAIN STREET",
"city": "NEW PRESTON",
"state": "CT",
"postal_code": "067772219",
"telephone_number": "860-868-9000",
"fax_number": "860-868-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRUCKUS",
"first_name": "JOSEPH",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "CT",
"license": "001640",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Preston, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.