Active NPI
Ronald Joel Wissuchek, PHARMACISTS
- Geriatric Pharmacist
- Hartford, CT
National Provider Identifier
1114226248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Pharmacist
- License
- 0006212
- Practice address
- 1291 Albany Ave
Hartford, CT 06112-2198 - Phone
- (860) 560-1881
- Fax
- (860) 560-0614
- NPI assigned
- Mar 15, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Pharmacist | 1835G0303X | 0006212 | CT | Primary |
Addresses
Primary practice location
1291 Albany Ave
Hartford, CT 06112-2198
Mailing address
1291 Albany Ave
Hartford, CT 06112-2198
Phone (860) 560-1881
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006212 | Other | CT | CONNECTICUT STATE PHARMACIST LIC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0006212 | CT | MD | Geriatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300147200000",
"number": "1114226248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1291 ALBANY AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061122198",
"telephone_number": "860-560-1881",
"fax_number": "860-560-0614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1291 ALBANY AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061122198",
"telephone_number": "860-560-1881",
"fax_number": "860-560-0614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISSUCHEK",
"first_name": "RONALD",
"middle_name": "JOEL",
"name_prefix": "Mr.",
"credential": "PHARMACISTS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-15",
"last_updated": "2011-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "1835G0303X",
"taxonomy_group": "",
"desc": "Pharmacist, Geriatric",
"state": "CT",
"license": "0006212",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICUT STATE PHARMACIST LIC",
"identifier": "0006212",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.