Active NPI
Jeffrey Mazzamurro, RPH
- Pharmacist
- Southington, CT
National Provider Identifier
1639775505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0014313
- Practice address
- 194 Hilltop Dr
Southington, CT 06489-2421 - Phone
- (860) 637-3495
- NPI assigned
- Dec 7, 2020
- Reactivated
- Feb 13, 2024
- 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 | PCT.0014313 | CT | Primary |
Addresses
Primary practice location
194 Hilltop Dr
Southington, CT 06489-2421
Mailing address
194 Hilltop Dr
Southington, CT 06489-2421
Phone (860) 637-3495
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 |
|---|---|---|---|
| PCT.0014313 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1639775505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "194 HILLTOP DR",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064892421",
"telephone_number": "860-637-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "194 HILLTOP DR",
"city": "SOUTHINGTON",
"state": "CT",
"postal_code": "064892421",
"telephone_number": "860-637-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZAMURRO",
"first_name": "JEFFREY",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-07",
"last_updated": "2024-02-13",
"certification_date": "2023-06-21",
"deactivation_date": "2023-06-21",
"reactivation_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0014313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.