Individual provider Active NPI

Vincent F Longo Jr., RPH

  • Pharmacist
  • Waterbury, CT
National Provider Identifier
1083904742
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6884 Issued in CT
Practice address
1030 Wolcott St
Waterbury, CT 06705-1316
Phone
(203) 754-3636
Fax
(203) 755-7059
NPI assigned
Apr 14, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 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 6884 CT Primary

Addresses

Primary practice location

1030 Wolcott St
Waterbury, CT 06705-1316

Mailing address

1030 Wolcott St
Waterbury, CT 06705-1316
Phone (203) 754-3636

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
Registered Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Connecticut Inc Past Accepting new patients
Rite Aid of Connecticut Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1083904742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051316",
            "telephone_number": "203-754-3636",
            "fax_number": "203-755-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051316",
            "telephone_number": "203-754-3636",
            "fax_number": "203-755-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGO",
        "first_name": "VINCENT",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "6884",
            "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 Apr 14, 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.