Individual provider Active NPI

Roberta Niemczyk Wisz

  • Pharmacist
  • Latrobe, PA
National Provider Identifier
1275177164
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP029267L Issued in PA
Practice address
108 Rocky Mountain CT
Latrobe, PA 15650-2409
Phone
(724) 454-2565
NPI assigned
Nov 4, 2019
Last updated
Nov 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP029267L PA Primary

Addresses

Primary practice location

108 Rocky Mountain CT
Latrobe, PA 15650-2409

Mailing address

108 Rocky Mountain CT
Latrobe, PA 15650-2409
Phone (724) 454-2565

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
RP029267LPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1275177164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ROCKY MOUNTAIN CT",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502409",
            "telephone_number": "724-454-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ROCKY MOUNTAIN CT",
            "city": "LATROBE",
            "state": "PA",
            "postal_code": "156502409",
            "telephone_number": "724-454-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISZ",
        "first_name": "ROBERTA",
        "middle_name": "NIEMCZYK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-04",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP029267L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latrobe, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.