Active NPI
Michael Vincent Ghizzoni, PHARMD
- Pharmacist
- Lebanon, PA
National Provider Identifier
1265008122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP454785
- Practice address
- 1700 S Lincoln Ave
Lebanon, PA 17042-7529 - Phone
- (518) 641-9580
- NPI assigned
- Jun 1, 2021
- 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 | RP454785 | PA | Primary |
Addresses
Primary practice location
1700 S Lincoln Ave
Lebanon, PA 17042-7529
Mailing address
1100 Jackson Blvd Apt C306
Lebanon, PA 17042-7091
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP454785 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622505600000",
"number": "1265008122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 JACKSON BLVD APT C306",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 S LINCOLN AVE",
"city": "LEBANON",
"state": "PA",
"postal_code": "170427529",
"telephone_number": "518-641-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHIZZONI",
"first_name": "MICHAEL",
"middle_name": "VINCENT",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-01",
"last_updated": "2021-06-01",
"certification_date": "2021-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP454785",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.