Connecticut Spine & Rehab, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CONNECTICUT SPINE & REHAB, LLC

Practice address

340 Capitol Ave
Bridgeport, CT 06606-5412

Phone

(203) 333-2377

Fax

(203) 333-2378

NPI assigned

Sep 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Chasanoff, D.C.

Title

Member

Phone

(203) 333-2377

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1831385913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 CAPITOL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065412",
            "telephone_number": "203-333-2377",
            "fax_number": "203-333-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 CAPITOL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065412",
            "telephone_number": "203-333-2377",
            "fax_number": "203-333-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT SPINE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "CHASANOFF",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-333-2377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Katherine L Connor, LCSW
• Rosabelle Therese Conover, APRN
• Pamela Conrad
• Douglas Jon Conroy, LICENCSE CLINICAL SO

• Chiropractor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Chiropractor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.