St. Vincent'S Multispecialty Group

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

ST. VINCENT'S MULTISPECIALTY GROUP

Practice address

1825 Barnum Ave
Stratford, CT 06614-5333

Phone

(203) 377-1777

NPI assigned

Dec 29, 2014

Organization subpart

Yes

Parent organization

ST.VINCENT'S MULTISPECIALTY GROUP, INCAs reported in NPPES

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

Authorized official

Name

John Gleckler

Title

Cfo

Phone

(203) 576-5412

Specialties & licenses 2

Addresses

Other names 1

• St.Vincent's Podiatry Center Other name

Part of

St Vincents Multispecialty Group Inc

Locations

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1376931311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 MAIN ST",
            "address_2": "SUITE 216",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065369",
            "telephone_number": "203-576-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066145333",
            "telephone_number": "203-377-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT'S MULTISPECIALTY GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST.VINCENT'S MULTISPECIALTY GROUP, INC",
        "enumeration_date": "2014-12-29",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "GLECKLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "203-576-5412"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St.Vincent's Podiatry Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jacqueline Spano, FNP
• Dailene Spencer, LCSW
• Shanique Spencer
• Grindel Spinks
• Subasree Srinivasan, M.D.
• St. Vincents Urgent Care LLC
• Sulton Stack Jr.
• Elizabeth J Staffieri
• Starr Health LLC
• Jenny L Starr, R.D.N., C.D.N.

• All providers in Stratford, CT
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.