Individual provider Active NPI

Mylaka Clinedinst

  • Pharmacist
  • East Windsor, CT
National Provider Identifier
1184057952
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0012712 Issued in CT
Practice address
74 Bridge St
East Windsor, CT 06088-9679
Phone
(860) 623-3327
NPI assigned
Aug 15, 2013
Last updated
Aug 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0012712 CT Primary

Addresses

Primary practice location

74 Bridge St
East Windsor, CT 06088-9679

Mailing address

15 Gordon LN
Enfield, CT 06082-4707
Phone (860) 709-7372

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

LicenseStateTypeSpecialty
PCT.0012712CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1184057952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 GORDON LN",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824707",
            "telephone_number": "860-709-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BRIDGE ST",
            "city": "EAST WINDSOR",
            "state": "CT",
            "postal_code": "060889679",
            "telephone_number": "860-623-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINEDINST",
        "first_name": "MYLAKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0012712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.