Individual provider Active NPI

Paul Eugene Brazzo, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Macungie, PA
National Provider Identifier
1356912570
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
RP032241L Issued in PA
Practice address
6465 Village LN Ste 9
Macungie, PA 18062-8474
Phone
(610) 421-8200
Fax
(610) 421-8400
NPI assigned
Jul 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RP032241L PA Primary

Addresses

Primary practice location

6465 Village LN Ste 9
Macungie, PA 18062-8474

Mailing address

721 Dorset Rd
Allentown, PA 18104-3385
Phone (610) 530-2250

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

LicenseStateTypeSpecialty
RP032241LPAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Macungie Community Pharmacy Inc CurrentSince Jul 17, 2021 Accepting new patients
Macungie RX Inc CurrentSince Dec 26, 2021 Accepting new patients

Locations

6465 Village Ln
Ste 9
Macungie, PA 18062
Phone (610) 421-8200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1356912570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 DORSET RD",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181043385",
            "telephone_number": "610-530-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 VILLAGE LN STE 9",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180628474",
            "telephone_number": "610-421-8200",
            "fax_number": "610-421-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZZO",
        "first_name": "PAUL",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "PA",
            "license": "RP032241L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macungie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.