NPIMap

Organization Active NPI

Joel Zuckerbraun Odpl

  • Optometrist
  • Jewett City, CT
National Provider Identifier
1699953729
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1014 Issued in CT
Legal business name
JOEL ZUCKERBRAUN ODPL
Practice address
8 North Main Street
Jewett City, CT 06351
Phone
(860) 376-2848
Fax
(860) 376-4821
NPI assigned
Jan 31, 2008
Last updated
Jan 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Authorized official

Name
Dr. Joel Zuckerbraun, ODNPI 1609835784
Title
President
Phone
(860) 376-2848

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1014 CT Primary
Optometrist 152W00000X 561 CT

Addresses

Primary practice location

8 North Main Street
Jewett City, CT 06351

Mailing address

PO Box 338
8 North Main Street
Jewett City, CT 06351
Phone (860) 376-2848

Other identifiers 1

IdentifierTypeStateIssuer
004194461MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1699953729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "address_2": "8 NORTH MAIN STREET",
            "city": "JEWETT CITY",
            "state": "CT",
            "postal_code": "06351",
            "telephone_number": "860-376-2848",
            "fax_number": "860-376-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 NORTH MAIN STREET",
            "city": "JEWETT CITY",
            "state": "CT",
            "postal_code": "06351",
            "telephone_number": "860-376-2848",
            "fax_number": "860-376-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL ZUCKERBRAUN ODPL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "ZUCKERBRAUN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-376-2848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "1014",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004194461",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jewett City, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.