Active NPI
Nelly Bella Malangko
- Pharmacist
- Waterbury, CT
National Provider Identifier
1699204628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT0013567
- Practice address
- 2000 N Main St
Waterbury, CT 06704-2364 - Phone
- (203) 591-3081
- NPI assigned
- Jun 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH236591 | MA | |
| Pharmacist | 183500000X | PCT0013567 | CT | Primary |
Addresses
Primary practice location
2000 N Main St
Waterbury, CT 06704-2364
Mailing address
18 Rocklyn Dr
West Simsbury, CT 06092-2627
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 |
|---|---|---|---|
| PCT0013567 | CT | MD | Pharmacist |
| PH236591 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496534400000",
"number": "1699204628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 ROCKLYN DR",
"city": "WEST SIMSBURY",
"state": "CT",
"postal_code": "060922627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067042364",
"telephone_number": "203-591-3081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALANGKO",
"first_name": "NELLY",
"middle_name": "BELLA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-04",
"last_updated": "2017-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH236591",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT0013567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.