Active NPI
Wanda Martinez
- Pharmacy Technician
- Bridgeport, CT
National Provider Identifier
1417347022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 0013007
- Practice address
- 165 Brookside Ave
Bridgeport, CT 06606-1502 - Phone
- (203) 683-8377
- NPI assigned
- Feb 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 0013007 | Primary |
Addresses
Primary practice location
165 Brookside Ave
Bridgeport, CT 06606-1502
Mailing address
165 Brookside Ave
Bridgeport, CT 06606-1502
Phone (203) 683-8377
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1417347022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 BROOKSIDE AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061502",
"telephone_number": "203-683-8377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 BROOKSIDE AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066061502",
"telephone_number": "203-683-8377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "WANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": null,
"license": "0013007",
"primary": true
}
],
"identifiers": [],
"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 Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.