Individual provider Active NPI

Anna Park, PHARMD

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1003104621
Registry record updated Jul 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03411800 Issued in NJ
Practice address
52 River Dr S
Jersey City, NJ 07310-2787
Phone
(201) 216-1117
NPI assigned
Jul 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03411800 NJ Primary

Addresses

Primary practice location

52 River Dr S
Jersey City, NJ 07310-2787

Mailing address

2700 John F Kennedy Blvd
Apt 202
Jersey City, NJ 07306-5751
Phone (551) 200-1484

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03411800NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Duane Reade Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310860800000",
    "number": "1003104621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 JOHN F KENNEDY BLVD",
            "address_2": "APT 202",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073065751",
            "telephone_number": "551-200-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 RIVER DR S",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073102787",
            "telephone_number": "201-216-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "ANNA",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-17",
        "last_updated": "2011-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03411800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.