Active NPI
Gary Jules Bango
- Community/Retail Pharmacy
- Waterford, CT
National Provider Identifier
1942708607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 0007343
- Practice address
- 155 Waterford Parkway N
Waterford, CT 06385-1208 - Phone
- (860) 447-3747
- NPI assigned
- Jan 29, 2018
- Last updated
- Jan 29, 2018
- 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 0007343 | CT | Primary |
Addresses
Primary practice location
155 Waterford Parkway N
Waterford, CT 06385-1208
Mailing address
155 Parkway North
Waterford, CT 06385
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0007343 | CT | MD | Community/Retail Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517184000000",
"number": "1942708607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 PARKWAY NORTH",
"city": "WATERFORD",
"state": "CT",
"postal_code": "06385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 WATERFORD PARKWAY N",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063851208",
"telephone_number": "860-447-3747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGO",
"first_name": "GARY",
"middle_name": "JULES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-29",
"last_updated": "2018-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CT",
"license": "0007343",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, CT
- Arnold E. Benak Jr. DMD LLC
- Ascension Naturopathic Healing Center LLC
- Amandeep Singh Aujla, M.D.
- Penelope Emma Avalos, M.S.W., L.C.S.W
- Lisa Jane Ballint, LCSW, LADC
- Marjorie Wood Barndt, D.M.D., MDSC
- Jennifer Eve Bartholomew, PT
- Jessie R Baudner, ANP BC
- Mary Christine Beaulieu, OD
- Josephine P Beebe, PHD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.