Active NPI
Stephen Mieczkowski, RPH
- Pharmacist
- Bridgeport, CT
National Provider Identifier
1184117616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0004802
- Practice address
- 4531 Main St
Bridgeport, CT 06606-1846 - Phone
- (203) 371-6972
- NPI assigned
- Jun 9, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0004802 | CT | Primary |
Addresses
Primary practice location
4531 Main St
Bridgeport, CT 06606-1846
Mailing address
546 Wilcoxson Ave
Stratford, CT 06614-4237
Phone (203) 218-8526
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PCT.0004802 | Other | CT | PHARMACIST |
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 |
|---|---|---|---|
| PCT.0004802 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528502400000",
"number": "1184117616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 WILCOXSON AVE",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144237",
"telephone_number": "203-218-8526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4531 MAIN ST",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061846",
"telephone_number": "203-371-6972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIECZKOWSKI",
"first_name": "STEPHEN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-09",
"last_updated": "2018-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0004802",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "PCT.0004802",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.