Individual provider Active NPI

Sean R Rusnack, CPHT

  • Pharmacy Technician
  • Cheshire, CT
National Provider Identifier
1053200931
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
19941 Issued in CT
Practice address
905 S Main St
Cheshire, CT 06410-3418
Phone
(203) 272-3255
Fax
(203) 699-9345
NPI assigned
Jul 2, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 19941 CT Primary

Addresses

Primary practice location

905 S Main St
Cheshire, CT 06410-3418

Mailing address

325 S Brooksvale Rd
Cheshire, CT 06410-3566

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
19941CTMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1751414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1053200931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S BROOKSVALE RD",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103418",
            "telephone_number": "203-272-3255",
            "fax_number": "203-699-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSNACK",
        "first_name": "SEAN",
        "middle_name": "R",
        "credential": "CPHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-02",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CT",
            "license": "19941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.