SAMANTHA BRODNICKI (NPI# 1043779796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043779796 |
| Entity Type | Individual |
| Full Name | SAMANTHA BRODNICKI |
| Credential | RPH |
| Practice Address |
915 Poquonnock Rd Groton CT 06340-4257 |
| Mailing Address |
710 Long Cove Rd Gales Ferry CT 06335-2005 |
| Practice Telephone | 8604460912 |
| Mailing Telephone | 8608844486 |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PCT.0014068 | CT | Pharmacy Service Providers |
| Street Address |
915 POQUONNOCK RD |
| City | GROTON |
| State | CT |
| Zip Code | 06340-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578667473 | Connecticut Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 915 Poquonnock Rd, Groton, CT 06340 | 2006-09-12 |
| 1740818608 | Elijah Andrews | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2020-03-27 |
| 1760956882 | Jane Nguyen | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2019-01-12 |
| 1033628250 | Michelle Grey | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2017-09-20 |
| 1134665318 | Jan Jens | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2017-01-12 |
| 1740738475 | Janet Mattiucci | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2016-09-11 |
| 1508226499 | Mark Pochal | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2016-03-04 |
| 1245667583 | Kathryn Walck | Nurse Practitioner | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2013-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497265185 | Thomas Anthony Keemon | Pharmacist | 995 Poquonnock Rd, Groton, CT 06340-4257 | 2017-10-06 |
| 1811418759 | Stephen Edward Lombardi | Pharmacist | 220 Route 12 Ste 1, Groton, CT 06340-3414 | 2017-06-30 |
| 1982852463 | Nora Meincke | Pharmacist | 760a Boston Road, Groton, MA 01450-2058 | 2008-09-09 |
| 1992859383 | Lori Louise Giedt | Pharmacist | 1205 N 1st St, Groton, SD 57445-0347 | 2007-01-22 |
| 1689286890 | Lajward Khan | Pharmacist | 441 Long Hill Rd, Groton, CT 06340-4149 | 2020-08-19 |
| 1750992673 | Jason Jack Close | Pharmacist | 32 Chicago Ave, Groton, CT 06340-4962 | 2020-08-13 |
| 1740818608 | Elijah Andrews | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2020-03-27 |
| 1497398739 | Kaitlyn Odonnell | Pharmacist | 32 Chicago Ave, Groton, CT 06340-4952 | 2019-10-18 |
| 1760956882 | Jane Nguyen | Pharmacist | 915 Poquonnock Rd, Groton, CT 06340-4257 | 2019-01-12 |
| 1053803361 | Emily Joy Kappes | Pharmacist | 1205 N 1st St, Groton, SD 57445-2329 | 2018-06-01 |
| Find all providers in GROTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.