Active NPI
Donna Mychaskiw, PD,MS
- Nutrition Support Pharmacist
- Middlebury, CT
National Provider Identifier
1164590915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Pharmacist
- License
- 6394
- Practice address
- 11 Abbott Farm Rd
Middlebury, CT 06762-1213 - Phone
- (203) 758-9280
- Fax
- (203) 758-9280
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nutrition Support Pharmacist | 1835N1003X | 6394 | CT | Primary |
Addresses
Primary practice location
11 Abbott Farm Rd
Middlebury, CT 06762-1213
Mailing address
11 Abbott Farm Rd
P.O. Box 1213
Middlebury, CT 06762-1213
Phone (203) 758-9280
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6394 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164590915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 ABBOTT FARM RD",
"address_2": "P.O. BOX 1213",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067621213",
"telephone_number": "203-758-9280",
"fax_number": "203-758-9280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 ABBOTT FARM RD",
"city": "MIDDLEBURY",
"state": "CT",
"postal_code": "067621213",
"telephone_number": "203-758-9280",
"fax_number": "203-758-9280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYCHASKIW",
"first_name": "DONNA",
"credential": "PD,MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "CT",
"license": "6394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, CT
- York P Moy, M.D.
- Suphichaya Muangman, M.D.
- Melanie Beth Mund, M.D.
- Anushree Mundhe, M.S
- Jacqueline Marisol Murillo, DNP- APRN
- Naugatuck Valley Cardiovascular Associates
- Naugatuck Valley Women'S Health Specialists, P.C.
- Naugatuck Valley Womens Health Specialists PC
- Nephrology and Hypertension Assoc PC
- Laura Jean Nesta, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.