Active NPI
Jordan Vaccaro
- Pharmacist
- Wallingford, CT
National Provider Identifier
1699551150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0016305
- Practice address
- 284 S Colony Rd
Wallingford, CT 06492-4554 - Phone
- (203) 265-6336
- Fax
- (203) 265-2364
- NPI assigned
- Aug 31, 2023
- Sex
- Female
- 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.0016305 | CT | Primary |
Addresses
Primary practice location
284 S Colony Rd
Wallingford, CT 06492-4554
Mailing address
1860 Hartford Tpke
North Haven, CT 06473-1248
Phone (203) 804-0851
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 |
|---|---|---|---|
| PCT.0016305 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
284 S Colony Rd
Wallingford, CT 06492
Phone (203) 265-6336
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693440000000",
"number": "1699551150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 HARTFORD TPKE",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064731248",
"telephone_number": "203-804-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 S COLONY RD",
"city": "WALLINGFORD",
"state": "CT",
"postal_code": "064924554",
"telephone_number": "203-265-6336",
"fax_number": "203-265-2364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACCARO",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-31",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0016305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wallingford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.