Individual provider Active NPI

Stefanie A Collomy, PHARMD

  • Pharmacist
  • New Haven, CT
National Provider Identifier
1013576685
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS65172 Issued in FL
Practice address
55 Park St
New Haven, CT 06511-5474
Phone
(203) 688-1111
NPI assigned
Jun 7, 2019
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0013312 CT
Pharmacist 183500000X PS65172 FL Primary

Addresses

Primary practice location

55 Park St
New Haven, CT 06511-5474

Mailing address

8511 Myslak Way Unit 3107
Pensacola, FL 32526-7897
Phone (860) 639-8530

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0013312CTMDPharmacist
PS65172FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1013576685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8511 MYSLAK WAY UNIT 3107",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325267897",
            "telephone_number": "860-639-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115474",
            "telephone_number": "203-688-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLOMY",
        "first_name": "STEFANIE",
        "middle_name": "A",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0013312",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS65172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.