NPIMap

Organization Active NPI

Buckland Ear Nose & Throat LLC

  • Specialist
  • Manchester, CT
National Provider Identifier
1881884641
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
021430 Issued in CT
Legal business name
BUCKLAND EAR NOSE & THROAT LLC
Practice address
360 Tolland Tpke
Suiter 1E
Manchester, CT 06042-1771
Phone
(860) 645-6675
NPI assigned
Jul 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Mrs. Betsy Graves
Title
Office Manager
Phone
(860) 645-6675

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 021430 CT Primary
Speech/Language/Hearing Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 235500000X 000196 CT
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

360 Tolland Tpke
Suiter 1E
Manchester, CT 06042-1771

Mailing address

360 Tolland Tpke
Suite 1E
Manchester, CT 06042-1771
Phone (860) 645-6675

National Provider Directory

National Provider Directory

Locations

360 Tolland Tpke
Ste 1E
Manchester, CT 06042
Phone (860) 645-6675

Practitioners 3

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": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1881884641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 TOLLAND TPKE",
            "address_2": "SUITE 1E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421771",
            "telephone_number": "860-645-6675",
            "fax_number": "860-645-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 TOLLAND TPKE",
            "address_2": "SUITER 1E",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060421771",
            "telephone_number": "860-645-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKLAND EAR NOSE & THROAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-645-6675",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CT",
            "license": "021430",
            "primary": true
        },
        {
            "code": "235500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": "CT",
            "license": "000196",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.