Active NPI
Leonard Copertino, MD
- Diagnostic Radiology Physician
- New London, CT
National Provider Identifier
1649207333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 021928
- Practice address
- 365 Montauk Ave
New London, CT 06320 - Phone
- (860) 444-5193
- Fax
- (860) 444-6851
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 021928 | CT | Primary |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320
Mailing address
365 Montauk Ave
New London, CT 06320
Phone (860) 444-5193
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021928 | CT | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649207333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "06320",
"telephone_number": "860-444-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "06320",
"telephone_number": "860-444-5193",
"fax_number": "860-444-6851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPERTINO",
"first_name": "LEONARD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CT",
"license": "021928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.