NPIMap

Individual provider Active NPI

Roger C Dezinno

  • Pharmacy Technician
  • Meriden, CT
National Provider Identifier
1649323981
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
2917 Issued in CT
Practice address
172 W Main St
Meriden, CT 06451-4104
Phone
(203) 235-6305
Fax
(203) 235-0244
NPI assigned
Jan 19, 2007
Last updated
May 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 2917 CT Primary

Addresses

Primary practice location

172 W Main St
Meriden, CT 06451-4104

Mailing address

174 Bradley Ave
Meriden, CT 06451-3914
Phone (203) 634-1042

Other identifiers 1

IdentifierTypeStateIssuer
2917OtherCTPHARMACY TEC

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

Organizations & group practices 4

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1649323981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 BRADLEY AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064513914",
            "telephone_number": "203-634-1042",
            "fax_number": "203-235-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 W MAIN ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064514104",
            "telephone_number": "203-235-6305",
            "fax_number": "203-235-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEZINNO",
        "first_name": "ROGER",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CT",
            "license": "2917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY TEC",
            "identifier": "2917",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.