Active NPI
Donna Medolla
- Pharmacist
- East Lyme, CT
National Provider Identifier
1003106865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 7056
- Practice address
- 340 Flanders Rd
East Lyme, CT 06333-1710 - Phone
- (860) 739-9007
- Fax
- (860) 739-7880
- NPI assigned
- Apr 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7056 | CT | Primary |
Addresses
Primary practice location
340 Flanders Rd
East Lyme, CT 06333-1710
Mailing address
340 Flanders Rd
East Lyme, CT 06333-1710
Phone (860) 739-9007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7056 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393804800000",
"number": "1003106865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 FLANDERS RD",
"city": "EAST LYME",
"state": "CT",
"postal_code": "063331710",
"telephone_number": "860-739-9007",
"fax_number": "860-739-7880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 FLANDERS RD",
"city": "EAST LYME",
"state": "CT",
"postal_code": "063331710",
"telephone_number": "860-739-9007",
"fax_number": "860-739-7880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDOLLA",
"first_name": "DONNA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-13",
"last_updated": "2014-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "7056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lyme, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.