Active NPI
Benny Chemmacheril Michael, PHARMD.
- Pharmacist
- Stratford, CT
National Provider Identifier
1073862769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0012452
- Practice address
- 1606 Barnum Ave
Stratford, CT 06614-5301 - Phone
- (203) 377-2851
- NPI assigned
- Sep 10, 2012
- 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 | PCT.0012452 | CT | Primary |
Addresses
Primary practice location
1606 Barnum Ave
Stratford, CT 06614-5301
Mailing address
25 Stonelea PL
New Rochelle, NY 10801-4506
Phone (914) 500-3719
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0012452 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347235200000",
"number": "1073862769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 STONELEA PL",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108014506",
"telephone_number": "914-500-3719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 BARNUM AVE",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066145301",
"telephone_number": "203-377-2851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "BENNY",
"middle_name": "CHEMMACHERIL",
"credential": "PHARMD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-10",
"last_updated": "2012-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0012452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.