Active NPI
Fred Robert London, PHARMACIST
- Pharmacist
- Wethersfield, CT
National Provider Identifier
1023308020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3823
- Practice address
- 657 Silas Deane Hwy
Wethersfield, CT 06109-3026 - Phone
- (860) 857-8000
- NPI assigned
- Apr 11, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 3823 | CT | Primary |
Addresses
Primary practice location
657 Silas Deane Hwy
Wethersfield, CT 06109-3026
Mailing address
516 Coppermill Rd
Wethersfield, CT 06109-4018
Phone (860) 563-4632
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 |
|---|---|---|---|
| 3823 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1023308020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 COPPERMILL RD",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061094018",
"telephone_number": "860-563-4632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "657 SILAS DEANE HWY",
"city": "WETHERSFIELD",
"state": "CT",
"postal_code": "061093026",
"telephone_number": "860-857-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONDON",
"first_name": "FRED",
"middle_name": "ROBERT",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "3823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wethersfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.