Organization Active NPI

Richard M Fanelli

  • Optician
  • Bloomfield, CT
National Provider Identifier
1144496621
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
05777 Issued in CT
Legal business name
RICHARD M FANELLI
Practice address
397 Cottage Grove Rd
Bloomfield, CT 06002-3119
Phone
(860) 243-8003
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Fanelli
Title
Owner
Phone
(860) 243-8003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X 05777 CT Primary

Addresses

Primary practice location

397 Cottage Grove Rd
Bloomfield, CT 06002-3119

Mailing address

397 Cottage Grove Rd
Bloomfield, CT 06002-3119

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1144496621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 COTTAGE GROVE RD",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 COTTAGE GROVE RD",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023119",
            "telephone_number": "860-243-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M FANELLI",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "FANELLI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-243-8003"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "05777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.