Active NPI
Brittany Bliss Manninen, RPH
- Pharmacist
- Watertown, NY
National Provider Identifier
1487976049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049496
- Practice address
- 929 Arsenal St
Watertown, NY 13601-2305 - Phone
- (315) 788-0309
- Fax
- (315) 788-1702
- NPI assigned
- Feb 24, 2010
- 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 | 049496 | NY | Primary |
Addresses
Primary practice location
929 Arsenal St
Watertown, NY 13601-2305
Mailing address
11562B Northern Blvd
Fort Drum, NY 13603-3509
Phone (315) 405-8373
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
| License | State | Type | Specialty |
|---|---|---|---|
| 049496 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1487976049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11562B NORTHERN BLVD",
"city": "FORT DRUM",
"state": "NY",
"postal_code": "136033509",
"telephone_number": "315-405-8373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 ARSENAL ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136012305",
"telephone_number": "315-788-0309",
"fax_number": "315-788-1702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNINEN",
"first_name": "BRITTANY",
"middle_name": "BLISS",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-24",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "049496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.