NPIMap

Organization Active NPI

Bristol Hospital Clinicians, P.C.

  • Cardiovascular Disease Physician
  • Bristol, CT
National Provider Identifier
1528017159
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
BRISTOL HOSPITAL CLINICIANS, P.C.
Practice address
1 Brewster Rd
Bristol, CT 06010-5142
Phone
(860) 585-3000
Fax
(860) 585-3907
NPI assigned
May 10, 2006
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Mr. Leonard Banco
Title
Vice President
Phone
(860) 585-3906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1 Brewster Rd
Bristol, CT 06010-5142

Mailing address

PO Box 2828
Bristol, CT 06011-2828
Phone (860) 585-3906

Other identifiers 1

IdentifierTypeStateIssuer
004116001MedicaidCT

National Provider Directory

National Provider Directory

Locations

653 Terryville Ave
Bristol, CT 06010
Phone (860) 589-7594

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1528017159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2828",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060112828",
            "telephone_number": "860-585-3906",
            "fax_number": "860-585-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BREWSTER RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105142",
            "telephone_number": "860-585-3000",
            "fax_number": "860-585-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPITAL CLINICIANS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "BANCO",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "860-585-3906",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004116001",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.