DAVID ALLAN VANGEERSDAELE (NPI# 1033646732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033646732 |
| Entity Type | Individual |
| Full Name | DAVID ALLAN VANGEERSDAELE |
| Credential | PHARMACIST |
| Practice Address |
763 Straits Tpke Stop & Shop #657 Watertown CT 06795-3318 |
| Mailing Address |
763 Straits Tpke Stop Watertown CT 06795-3318 |
| Practice Telephone | 8602747461 |
| Practice Fax Number | 8602746124 |
| Mailing Telephone | 8602747461 |
| Mailing Fax Number | 8602746124 |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2017-05-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 0005564 | CT | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | NABP | 409257 | 01 |
| Street Address |
763 STRAITS TPKE STOP & SHOP #657 |
| City | WATERTOWN |
| State | CT |
| Zip Code | 06795-3318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396232187 | Watertown Wellness Center LLC | Community/Behavioral Health | 116 Georgetown Drive, Watertown, CT 06795 | 2018-04-17 |
| 1134569833 | Kara Marie Iacoviello | Occupational Therapist | 18 Wilder St, Watertown, CT 06795 | 2013-06-27 |
| 1821348871 | Pamela D Siemon | Social Worker | 51 Depot St Ste 207, Watertown, CT 06795 | 2012-09-18 |
| 1073891222 | Alexander Pantelis Tinios | Student in an Organized Health Care Education/Training Program | 163 Townline Hwy, Watertown, CT 06795 | 2011-07-21 |
| 1083919757 | Connecticut Music Therapy Services, LLC | Music Therapist | 51 Depot St., Suite 214, Watertown, CT 06795 | 2011-01-11 |
| 1083841456 | Erica Lee Opromollo | Social Worker | 35 Scott Ave, Watertown, CT 06795 | 2009-06-12 |
| 1033306816 | Stone Chiropractic LLC | Chiropractor | 51 Depot Square, Watertown, CT 06795 | 2007-09-26 |
| 1174640205 | Sheila Whitman | Counselor | 686 Main Street, Watertown, CT 06795 | 2007-03-23 |
| 1225146848 | Ronald Joseph Dandrea | Internal Medicine | 51 Depot Street, Watertown, CT 06795 | 2006-08-25 |
| 1417344607 | Peter Anthony Ferrante | Podiatrist | 777 Echo Lake Rd Unit F, Watertown, CT 06795 | 2015-04-25 |
| Find all providers in zip 06795 | ||||
| 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 |
|---|---|---|---|---|
| 1730538844 | Kathleen S. Lepine | Pharmacist | 747 Ball Ave, Watertown, NY 13601-9900 | 2016-06-09 |
| 1770875270 | Laura Blair | Pharmacist | 1271 Main St, Watertown, CT 06795-3107 | 2011-05-03 |
| 1316262447 | Brandy Barniak | Pharmacist | 27772 Middle Rd, Watertown, NY 13601-5766 | 2010-03-31 |
| 1043533862 | Stephen Louis St. Joseph | Pharmacist | 20823 Nys Rt #3, Watertown, NY 13601 | 2010-03-08 |
| 1790008894 | Karen Mary Flick | Pharmacist | 22056 Us Rt 11, Watertown, NY 13601 | 2010-03-04 |
| 1417187816 | Lynn M Odett | Pharmacist | 1655 State Street, Watertown, NY 13601-3106 | 2009-07-20 |
| 1417127747 | Ira Roger Siegel | Pharmacist | 315 Arscenal St, Watertown, NY 13601 | 2008-03-03 |
| 1831373190 | Jack Kriesick | Pharmacist | 22056 Us Rte 11, Watertown, NY 13601 | 2007-12-21 |
| 1396927547 | Megan Whitney | Pharmacist | 1328 Washington St, Watertown, NY 13601-4532 | 2007-11-29 |
| 1619158342 | Edward Lloyd Zeilnhofer | Pharmacist | 1222 Arsenal St, Watertown, NY 13601-2230 | 2007-11-21 |
| Find all providers in WATERTOWN | ||||
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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.