Individual provider Active NPI

Thomas Warzecha

  • Pharmacist
  • New London, CT
National Provider Identifier
1669051264
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0015331 Issued in CT
Practice address
365 Montauk Ave
New London, CT 06320-4700
Phone
(860) 442-0711
NPI assigned
Apr 2, 2021
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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.0015331 CT Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320-4700

Mailing address

97 Westwood LN
Middletown, CT 06457-1964

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

State licenses

LicenseStateTypeSpecialty
PCT.0015331CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1669051264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 WESTWOOD LN",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARZECHA",
        "first_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0015331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.