Active NPI
Phillip I Wizwer, RPH
- Pharmacist
- Boston, MA
National Provider Identifier
1619171816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14694
- Practice address
- 179 Longwood Ave
Boston, MA 02115-5896 - Phone
- (617) 732-2972
- Fax
- (617) 732-2244
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- 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 | 14694 | MA | Primary |
Addresses
Primary practice location
179 Longwood Ave
Boston, MA 02115-5896
Mailing address
40 Clarissa Rd
Chelmsford, MA 01824-4739
Phone (978) 256-7886
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 |
|---|---|---|---|
| 14694 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619171816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CLARISSA RD",
"city": "CHELMSFORD",
"state": "MA",
"postal_code": "018244739",
"telephone_number": "978-256-7886",
"fax_number": "617-732-2244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155896",
"telephone_number": "617-732-2972",
"fax_number": "617-732-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIZWER",
"first_name": "PHILLIP",
"middle_name": "I",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "14694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.