Individual provider Active NPI

Antonia Valassis

  • Pharmacist
  • Norwalk, CT
National Provider Identifier
1871774026
Registry record updated Aug 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT0011279 Issued in CT
Practice address
120 New Canaan Ave
Norwalk, CT 06850-2643
Phone
(203) 846-2398
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 050786 NY
Pharmacist 183500000X PCT0011279 CT Primary

Addresses

Primary practice location

120 New Canaan Ave
Norwalk, CT 06850-2643

Mailing address

120 New Canaan Ave
Norwalk, CT 06850-2643
Phone (203) 846-2398

Other identifiers 1

IdentifierTypeStateIssuer
01481727MedicaidNY

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

LicenseStateTypeSpecialty
PCT0011279CTMDPharmacist
050786NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1871774026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 NEW CANAAN AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502643",
            "telephone_number": "203-846-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NEW CANAAN AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068502643",
            "telephone_number": "203-846-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALASSIS",
        "first_name": "ANTONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050786",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT0011279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01481727",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.