Active NPI
Krisan Bradley
- Other Technician
- Orange, CT
National Provider Identifier
1487045860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- PTN.0012061
- Practice address
- 25 Boston Post Rd
Orange, CT 06477-3203 - Phone
- (203) 859-3695
- Fax
- (203) 937-2536
- NPI assigned
- Feb 6, 2015
- 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 |
|---|---|---|---|---|
| Other Technician | 247200000X | PTN.0012061 | CT | Primary |
Addresses
Primary practice location
25 Boston Post Rd
Orange, CT 06477-3203
Mailing address
25 Boston Post Rd
Orange, CT 06477-3203
Phone (203) 859-3695
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PTN.0012061 | Other | CT | PHARMACY TECHNICIAN |
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 |
|---|---|---|---|
| PTN.0012061 | CT | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1487045860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773203",
"telephone_number": "203-859-3695",
"fax_number": "203-937-2536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 BOSTON POST RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773203",
"telephone_number": "203-859-3695",
"fax_number": "203-937-2536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "KRISAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-06",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "CT",
"license": "PTN.0012061",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY TECHNICIAN",
"identifier": "PTN.0012061",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.