Individual provider Active NPI

Viljan Kristollari, PHARMD

  • Pharmacist
  • Waterbury, CT
National Provider Identifier
1508145525
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0012050 Issued in CT
Practice address
141 Meriden Rd
Waterbury, CT 06705-1937
Phone
(203) 573-0378
NPI assigned
Aug 8, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0012050 CT Primary

Addresses

Primary practice location

141 Meriden Rd
Waterbury, CT 06705-1937

Mailing address

72 Richmond Ave Apt 3
Waterbury, CT 06705-4402
Phone (203) 510-2122

Other identifiers 1

IdentifierTypeStateIssuer
PCT.0012050OtherCTPHARMACIST LICENSE

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PCT.0012050CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Connecticut Inc Past Accepting new patients
Rite Aid of Connecticut Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1508145525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 RICHMOND AVE APT 3",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067054402",
            "telephone_number": "203-510-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MERIDEN RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051937",
            "telephone_number": "203-573-0378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTOLLARI",
        "first_name": "VILJAN",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0012050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PCT.0012050",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.