Individual provider Active NPI

Michael Andrew Czerniewski, PHARMD

  • Pharmacist
  • North Branford, CT
National Provider Identifier
1063706125
Registry record updated Jun 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0011161 Issued in CT
Practice address
47 Lake Rd
North Branford, CT 06471-1254
Phone
(617) 519-1825
NPI assigned
Jun 7, 2011
Last updated
Jun 7, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0011161 CT Primary

Addresses

Primary practice location

47 Lake Rd
North Branford, CT 06471-1254

Mailing address

47 Lake Rd
North Branford, CT 06471-1254
Phone (617) 519-1825

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
PCT.0011161CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1063706125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 LAKE RD",
            "city": "NORTH BRANFORD",
            "state": "CT",
            "postal_code": "064711254",
            "telephone_number": "617-519-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 LAKE RD",
            "city": "NORTH BRANFORD",
            "state": "CT",
            "postal_code": "064711254",
            "telephone_number": "617-519-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERNIEWSKI",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-07",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0011161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.