NPIMap

Organization Active NPI

Susan C Danberg OD PC

  • Optometrist
  • Glastonbury, CT
National Provider Identifier
1447553482
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1078 Issued in CT
Legal business name
SUSAN C DANBERG OD PC
Practice address
212 New London Tpke
Glastonbury, CT 06033-4202
Phone
(860) 657-9189
NPI assigned
Dec 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Dr. Susan C Danberg, OD
Title
Owner
Phone
(860) 657-9189

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1078 CT Primary
Vision Therapy OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WV0400X 1078 CT

Addresses

Primary practice location

212 New London Tpke
Glastonbury, CT 06033-4202

Mailing address

212 New London Tpke
Glastonbury, CT 06033-4202
Phone (860) 657-9189

National Provider Directory

National Provider Directory

Locations

212 New London Tpke
Glastonbury, CT 06033
Phone (860) 657-9189

NPI Registry JSON

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

{
    "created_epoch": "1292284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1447553482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 NEW LONDON TPKE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334202",
            "telephone_number": "860-657-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 NEW LONDON TPKE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334202",
            "telephone_number": "860-657-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN C DANBERG OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-14",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "DANBERG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-657-9189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "CT",
            "license": "1078",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "CT",
            "license": "1078",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Dec 14, 2010; 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.