Organization Active NPI

Robert G. Lussier, M.D., LLC

  • Psychiatry Physician
  • Glastonbury, CT
National Provider Identifier
1154509347
Registry record updated Feb 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
026123 Issued in CT
Legal business name
ROBERT G. LUSSIER, M.D., LLC
Practice address
36 Welles St
Suite 230
Glastonbury, CT 06033-2080
Phone
(860) 652-0472
Fax
(860) 652-3431
NPI assigned
Feb 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2008

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

Authorized official

Name
Dr. Robert George Lussier, M.D.
Title
Owner
Phone
(860) 652-0472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 026123 CT Primary

Addresses

Primary practice location

36 Welles St
Suite 230
Glastonbury, CT 06033-2080

Mailing address

36 Welles St
Suite 230
Glastonbury, CT 06033-2080
Phone (860) 652-0472

Other identifiers 1

IdentifierTypeStateIssuer
C03503OtherCTMEICARE GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

36 Welles St
Ste 230
Glastonbury, CT 06033
Phone (203) 454-6722

Practitioners & affiliated clinicians

Practitioners 1

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": "1202601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202601600000",
    "number": "1154509347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WELLES ST",
            "address_2": "SUITE 230",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332080",
            "telephone_number": "860-652-0472",
            "fax_number": "860-652-3431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WELLES ST",
            "address_2": "SUITE 230",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332080",
            "telephone_number": "860-652-0472",
            "fax_number": "860-652-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G. LUSSIER, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-10",
        "last_updated": "2008-02-10",
        "status": "A",
        "authorized_official_last_name": "LUSSIER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-652-0472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "026123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEICARE GROUP NUMBER",
            "identifier": "C03503",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.