Active NPI
Wendy Roccisano Brody, R.PH.
- Pharmacist
- Putnam, CT
National Provider Identifier
1851566426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 8997
- Practice address
- 203 Kennedy Dr
Putnam, CT 06260-1628 - Phone
- (860) 963-7230
- Fax
- (860) 928-6298
- NPI assigned
- Apr 24, 2008
- 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 | 8997 | CT | Primary |
| Pharmacist | 183500000X | 24236 | MA |
Addresses
Primary practice location
203 Kennedy Dr
Putnam, CT 06260-1628
Mailing address
203 Kennedy Dr
Putnam, CT 06260-1628
Phone (860) 963-7230
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24236 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1851566426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "203 KENNEDY DR",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601628",
"telephone_number": "860-963-7230",
"fax_number": "860-928-6298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 KENNEDY DR",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601628",
"telephone_number": "860-963-7230",
"fax_number": "860-928-6298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODY",
"first_name": "WENDY",
"middle_name": "ROCCISANO",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "8997",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "24236",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Putnam, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.