DR. KELLY S BRISTOL (NPI# 1790275188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790275188 |
| Entity Type | Individual |
| Full Name | DR. KELLY S BRISTOL |
| Credential | PHARMD |
| Practice Address |
844 N Colony Rd Wallingford CT 06492-2410 |
| Practice Telephone | 2032696633 |
| Mailing Telephone | 2032696633 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
0010933 | CT | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992208409 | Kelly Jean Bristol | Behavior Technician | 1855 2nd St Ste B, Concord, CA 94519-2623 | 2018-03-10 |
| Street Address |
844 N COLONY RD |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043265697 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2006-05-23 |
| 1700445632 | Priscilla Kuo | Optometrist | 844 N Colony Rd, Wallingford, CT 06492-2771 | 2019-06-13 |
| 1598244998 | Merna Marlin Refat Khilla | Optometrist | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2018-08-07 |
| 1902312044 | Josephine Gulino II | Pharmacist | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2017-12-27 |
| 1922475821 | Dil Sagar Sharma | Pharmacist | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2015-08-26 |
| 1750781209 | Advantage Eye Care, LLC | Optometrist | 844 N Colony Rd, Vision Center 2371 Located Inside Walmart, Wallingford, CT 06492-2410 | 2014-09-02 |
| 1417242330 | Angela Dunphy | Technician/Technologist | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2011-06-20 |
| 1609003789 | Rosamaria Piccolo Robison | Technician/Technologist | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2009-06-16 |
| 1174540462 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 844 N Colony Rd, Wallingford, CT 06492-2410 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982687141 | John Anthony Williamson | Pharmacist | 415 Golfview Rd, Wallingford, PA 19086-6408 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619524584 | Anshu Chen | Pharmacist | 290 Box Mountain Dr, Vernon, CT 06066-6309 | 2019-08-24 |
| 1841654225 | Ramalakshmi Devadi | Pharmacist | 1035 Washington Blvd, Stamford, CT 06901-2204 | 2016-04-11 |
| 1013293851 | Alec Theis | Pharmacist | 3265 Berlin Tpke, T1802, Newington, CT 06111-5101 | 2011-10-25 |
| 1457588220 | Maria A Summa | Pharmacist | 114 Woodland Street Department of Pharmacy, Saint Francis Hospital and Medical Center, Hartford, CT 06105 | 2009-06-18 |
| 1609990159 | Lorna Zammett | Pharmacist | 112 Medford St, Bristol, CT 06010-3683 | 2007-03-19 |
| 1528192812 | David Nederhood | Pharmacist | 55 Northwood Dr, Guilford, CT 06437-1127 | 2007-03-16 |
| 1518021138 | Craig Ian Coleman | Pharmacist | 80 Seymour St # Cb309, Hartford Hospital, Hartford, CT 06102-8000 | 2006-12-20 |
| 1053474619 | Fei Wang | Pharmacist | 79 Retreat Ave, Adult Primary Care Practice, Hartford, CT 06106-2527 | 2006-12-18 |
| 1285727354 | Richard Lawrence Kubarek | Pharmacist | 114 Beebe Hill Rd, Falls Village, CT 06031-1612 | 2006-10-02 |
| 1700996733 | Jaime L Correia | Pharmacist | 555 Willard Ave # 119, Newington, CT 06111-2631 | 2006-08-31 |
| Find all providers with the same taxonomy | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
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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.