Active NPI
Yustyna Bobak
- Pharmacist
- Taftville, CT
National Provider Identifier
1467163147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0016025
- Practice address
- 3 N 2ND Ave
Taftville, CT 06380-1407 - Phone
- (860) 383-2013
- NPI assigned
- Dec 13, 2022
- Last updated
- Dec 13, 2022
- Sex
- Female
- 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.0016025 | CT | Primary |
Addresses
Primary practice location
3 N 2ND Ave
Taftville, CT 06380-1407
Mailing address
41 Szegda Rd
Columbia, CT 06237-1227
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0016025 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TRCP LLC | Current | Accepting new patients | |
| TRCP LLC | Past | Accepting new patients |
Locations
3 N 2nd Ave
Taftville, CT 06380
Phone (860) 345-3607
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Long Term Care Pharmacy
- Taftville, CT
- NPI 1902421050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1467163147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 SZEGDA RD",
"city": "COLUMBIA",
"state": "CT",
"postal_code": "062371227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 N 2ND AVE",
"city": "TAFTVILLE",
"state": "CT",
"postal_code": "063801407",
"telephone_number": "860-383-2013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBAK",
"first_name": "YUSTYNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-13",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0016025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taftville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.