Individual provider Active NPI

Ibrahim Zaidan

  • Pharmacist
  • Rocky Hill, CT
National Provider Identifier
1083061766
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
12528 Issued in CT
Practice address
38 Concord Dr
Rocky Hill, CT 06067-2143
Phone
(832) 868-5961
NPI assigned
May 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 12528 CT Primary

Addresses

Primary practice location

38 Concord Dr
Rocky Hill, CT 06067-2143

Mailing address

38 Concord Dr
Rocky Hill, CT 06067-2143
Phone (832) 868-5961

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

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1083061766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 CONCORD DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672143",
            "telephone_number": "832-868-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 CONCORD DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672143",
            "telephone_number": "832-868-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAIDAN",
        "first_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "12528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.