NPIMap

Organization Active NPI

Glastonbury Osteopathic, LLC

  • Family Medicine Physician
  • Glastonbury, CT
National Provider Identifier
1679667604
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
000536 Issued in CT
Legal business name
GLASTONBURY OSTEOPATHIC, LLC
Practice address
59 Sycamore St
Suite 301
Glastonbury, CT 06033-4535
Phone
(860) 659-5999
Fax
(860) 633-9423
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ernest Luke Squatrito, D.O.NPI 1194724054
Title
Physician/Owner
Phone
(860) 659-5999

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 000536 CT Primary

Addresses

Primary practice location

59 Sycamore St
Suite 301
Glastonbury, CT 06033-4535

Mailing address

59 Sycamore St
Suite 301
Glastonbury, CT 06033-4535
Phone (860) 659-5999

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679667604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SYCAMORE ST",
            "address_2": "SUITE 301",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334535",
            "telephone_number": "860-659-5999",
            "fax_number": "860-633-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 SYCAMORE ST",
            "address_2": "SUITE 301",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334535",
            "telephone_number": "860-659-5999",
            "fax_number": "860-633-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASTONBURY OSTEOPATHIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SQUATRITO",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "860-659-5999",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "000536",
            "primary": true
        }
    ],
    "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 Aug 22, 2020; 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.