Active NPI
Ellen Sue Moses, R.PH.
- Pharmacist
- Glastonbury, CT
National Provider Identifier
1114170784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8506
- Practice address
- 79 Natchaug Dr
Glastonbury, CT 06033-1913 - Phone
- (860) 643-9663
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8506 | CT | Primary |
| Pharmacist | 183500000X | 4537 | NM |
Addresses
Primary practice location
79 Natchaug Dr
Glastonbury, CT 06033-1913
Mailing address
79 Natchaug Dr
Glastonbury, CT 06033-1913
Phone (860) 643-9663
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8506 | CT | MD | Pharmacist |
| 4537 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1114170784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 NATCHAUG DR",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060331913",
"telephone_number": "860-643-9663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 NATCHAUG DR",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060331913",
"telephone_number": "860-643-9663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSES",
"first_name": "ELLEN",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "8506",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "4537",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.