Eastern Connecticut Neurology Specialist LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

039584 Issued in CT

Legal business name

EASTERN CONNECTICUT NEUROLOGY SPECIALIST LLC

Practice address

394 W Center St
Manchester, CT 06040-4735

Phone

(860) 647-9183

Fax

(860) 647-0582

NPI assigned

Jun 12, 2006

Last updated

Apr 24, 2014By 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

Jessica Woodruff

Title

Office Manager

Phone

(860) 647-9183

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 4

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.

• Jacqueline Baker, APRN

  • Family Nurse Practitioner
  • Meriden, CT
  • NPI 1548477433
  NPD (past)
• Jennifer A Colucci, APRN

  • Acute Care Nurse Practitioner
  • Hartford, CT
  • NPI 1558364653
  NPD (past)
• Kristin Lund, PA-C

  • Physician Assistant
  • Manchester, CT
  • NPI 1821295296
  NPD (past)
• Julius F Deiparine, MD

  • Neurology Physician
  • Beaumont, TX
  • NPI 1790892396
  NPD (past)

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1932141298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3262",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662162",
            "telephone_number": "860-896-1422",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 W CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404735",
            "telephone_number": "860-647-9183",
            "fax_number": "860-647-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN CONNECTICUT NEUROLOGY SPECIALIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "WOODRUFF",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-647-9183"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "039584",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "005619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C03446",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tommy Mathew Easow, PHARM.D.
• East Hartford Cab Company Inc (Ace Taxi)
• Eastern Connecticut Cardiology Associates LLC
• Eastern Connecticut Imaging PC
• Eastern Connecticut Medical Professionals Foundation Inc (Eastern CT Medical Professionals)
• Eastern Connecticut Pathology Consultants, PC
• Eastern Connectitcut Medical Professionals
• Eastern Rehabilitation Network
• Ecs-03 LLC
• Amanda Edgar

• Neurology Physician in Manchester, CT
• Providers in Manchester, CT by specialty
• Neurology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.