Individual provider Active NPI

Mahwish Makhdoom

  • Pharmacist
  • Waterbury, CT
National Provider Identifier
1033648464
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
13822 Issued in CT
Practice address
464 Reidville Drive
Waterbury, CT 06705
Phone
(860) 329-7319
NPI assigned
Jun 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 13822 CT Primary

Addresses

Primary practice location

464 Reidville Drive
Waterbury, CT 06705

Mailing address

464 Reidville Dr
Waterbury, CT 06705-2650

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

LicenseStateTypeSpecialty
13822CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1033648464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 REIDVILLE DR",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067052650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 REIDVILLE DRIVE",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06705",
            "telephone_number": "860-329-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHDOOM",
        "first_name": "MAHWISH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "13822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; 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.