Keenan Russell & Moore Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

License

001177 Issued in CT

Legal business name

KEENAN RUSSELL & MOORE INC

Practice address

650 West Ave
Norwalk, CT 06850-4020

Phone

(203) 866-2775

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Jablonski, LO

Title

President

Phone

(203) 866-2775

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1467510727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 WEST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068504020",
            "telephone_number": "203-866-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 WEST AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068504020",
            "telephone_number": "203-866-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEENAN RUSSELL & MOORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "JABLONSKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-866-2775",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LO"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "CT",
            "license": "001177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004036364",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanjot Kaur, M.D.
• Roger Henry Kaye, MD,JD,FACS
• Patricia R Keane, PTA
• Neil Keaney, PA-C
• Melodie Keen, LADC
• Serena Keklik, PT
• David Kell, PHARMD
• Melissa A Kelleher, LCSW
• Chana Judith Kelley, APRN
• Aidan Kelly

• Optician in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Optician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.