Traci Marie Ospalek, RPH
Individual provider Active NPI Pharmacist · Waterbury, CT
NPI 1750802427 · NPPES record last updated Jul 3, 2017
Key facts
- NPI
- 1750802427
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 8167 (CT)
- Practice address
- 410 Reidville Dr
Waterbury, CT 06705-2660 - Phone
- (203) 755-5814
- NPI assigned
- Jul 3, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8167 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stop and Shop Supermarket Co LLC | Past | Accepting new patients | |
| The Stop & Shop Supermarket Company, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 8167 | CT | Yes |
Addresses
Primary practice location
410 Reidville Dr
Waterbury, CT 06705-2660
Mailing address
9 Erica LN
Wolcott, CT 06716-1427
Phone (203) 879-2718
NPI Registry JSON
{
"created_epoch": "1499040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499040000000",
"number": "1750802427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 ERICA LN",
"city": "WOLCOTT",
"state": "CT",
"postal_code": "067161427",
"telephone_number": "203-879-2718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 REIDVILLE DR",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067052660",
"telephone_number": "203-755-5814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSPALEK",
"first_name": "TRACI",
"middle_name": "MARIE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-03",
"last_updated": "2017-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "8167",
"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. Record last updated by the provider on Jul 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.