Individual provider Active NPI

Andrew Anthony Fyne, PHARM D

  • Pharmacist
  • Canton, CT
National Provider Identifier
1780230714
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PTN.0014593 Issued in CT
Practice address
220 Albany Tpke
Canton, CT 06019-2565
Phone
(860) 693-8329
NPI assigned
Aug 15, 2019
Last updated
May 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PTN.0014593 CT Primary

Addresses

Primary practice location

220 Albany Tpke
Canton, CT 06019-2565

Mailing address

777 Main St Unit 409
Hartford, CT 06103-2309
Phone (718) 710-8432

Other identifiers 1

IdentifierTypeStateIssuer
PCT.0014593MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL rxm.11604@gmail.com Health Information Exchange (HIE)

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PTN.0014593CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge Care Health Pharmacy LLC Current Accepting new patients
Bridge Pharmacy LLC Current Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1780230714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 MAIN ST UNIT 409",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061032309",
            "telephone_number": "718-710-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 ALBANY TPKE",
            "city": "CANTON",
            "state": "CT",
            "postal_code": "060192565",
            "telephone_number": "860-693-8329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYNE",
        "first_name": "ANDREW",
        "middle_name": "ANTHONY",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PTN.0014593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PCT.0014593",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rxm.11604@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email adress",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "220 Albany Tpke",
            "city": "Canton",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060192565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, CT

Sources for this page

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

Verify at the official NPI Registry.