Matthew Arellano

Individual provider Active NPI Pharmacist · Wallingford, CT

NPI 1982281580 · NPPES record last updated Mar 28, 2021

Key facts

NPI
1982281580
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PCT.0015315 (CT)
Practice address
891 N Colony Rd
Wallingford, CT 06492-2437
Phone
(203) 294-8890
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PCT.0015315CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut CVS Pharmacy LLC Past
since Apr 6, 2021
Accepting new patients
Connecticut CVS Pharmacy LLC Past
since Apr 6, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0015315 CT Yes

Addresses

Primary practice location

891 N Colony Rd
Wallingford, CT 06492-2437

Mailing address

122 Grandview Ave
Wallingford, CT 06492-5109

Other identifiers

IdentifierTypeStateIssuer
148889985OtherCTDRIVERS LICENSE

Other providers in Wallingford, CT

All providers in Wallingford, CT · Pharmacist in Connecticut

Sources for this page

Verify at the official NPI Registry.