Active NPI
Constantino Distefano
- Pharmacist
- Norwalk, CT
National Provider Identifier
1871914929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5945
- Practice address
- 189 Main St
Norwalk, CT 06851-3607 - Phone
- (203) 845-0616
- NPI assigned
- Dec 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 5945 | CT | Primary |
Addresses
Primary practice location
189 Main St
Norwalk, CT 06851-3607
Mailing address
189 Main St
Norwalk, CT 06851-3607
Phone (203) 845-0616
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387152000000",
"number": "1871914929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "189 MAIN ST",
"city": "NORWALK",
"state": "CT",
"postal_code": "068513607",
"telephone_number": "203-845-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 MAIN ST",
"city": "NORWALK",
"state": "CT",
"postal_code": "068513607",
"telephone_number": "203-845-0616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISTEFANO",
"first_name": "CONSTANTINO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-16",
"last_updated": "2013-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "5945",
"primary": true
}
],
"identifiers": [],
"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 Dec 16, 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.