Canton Interventional Radiologist Group PC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

CANTON INTERVENTIONAL RADIOLOGIST GROUP PC

Practice address

110 Albany Tpke Ste 209
Canton, CT 06019-2549

Phone

(860) 693-4060

Fax

(860) 693-4065

NPI assigned

Sep 20, 2019

Last updated

Sep 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lorena Esparza

Title

Revenue Cycle Manager

Phone

(630) 725-2764

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568937600000",
    "number": "1659922748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 300",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151069",
            "telephone_number": "630-725-2700",
            "fax_number": "833-842-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ALBANY TPKE STE 209",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192549",
            "telephone_number": "860-693-4060",
            "fax_number": "860-693-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTON INTERVENTIONAL RADIOLOGIST GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2019-09-20",
        "status": "A",
        "authorized_official_last_name": "ESPARZA",
        "authorized_official_first_name": "LORENA",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "630-725-2764"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Desautels Brickman
• Ian Brokaw, DPT
• Carolyn Brown, OTD, OTR/L
• Jennifer Cannon, APRN
• Canton Geriatrics PLLC
• Canton Physical Therapy, LLC
• Canton Valley Dental LLC
• Carolyn Brown Otd Mobile Therapy, LLC
• Jo-Ann Castellone, D.M.D.
• Andrew Cavanaugh

• Vascular & Interventional Radiology Physician in Canton, CT
• Providers in Canton, CT by specialty
• Vascular & Interventional Radiology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; 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.