Active NPI
Praveen Kumar Dhulipalla
- Pharmacist
- Avon, CT
National Provider Identifier
1669814976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT0010979
- Practice address
- 28 Buckingham Rd
Avon, CT 06001-5104 - Phone
- (203) 567-0135
- NPI assigned
- Jul 28, 2013
- 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 | PCT0010979 | CT | Primary |
Addresses
Primary practice location
28 Buckingham Rd
Avon, CT 06001-5104
Mailing address
28 Buckingham Rd
Avon, CT 06001-5104
Phone (203) 567-0135
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT0010979 | CT | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430438400000",
"number": "1669814976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 BUCKINGHAM RD",
"city": "AVON",
"state": "CT",
"postal_code": "060015104",
"telephone_number": "203-567-0135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 BUCKINGHAM RD",
"city": "AVON",
"state": "CT",
"postal_code": "060015104",
"telephone_number": "203-567-0135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHULIPALLA",
"first_name": "PRAVEEN",
"middle_name": "KUMAR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-07-28",
"last_updated": "2015-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT0010979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.