Individual provider Active NPI

Mariam Gergis, RPH

  • Pharmacist
  • Somerville, NJ
National Provider Identifier
1033417860
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03408800 Issued in NJ
Practice address
132 N Gaston Ave
Somerville, NJ 08876-2419
Phone
(908) 722-3444
NPI assigned
Mar 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 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 28RI03408800 NJ Primary

Addresses

Primary practice location

132 N Gaston Ave
Somerville, NJ 08876-2419

Mailing address

2509 Maple Ave
South Plainfield, NJ 07080-5422
Phone (908) 510-9636

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03408800NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of New Jersey Inc Past Accepting new patients
Rite Aid of New Jersey Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299024000000",
    "number": "1033417860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 MAPLE AVE",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805422",
            "telephone_number": "908-510-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 N GASTON AVE",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762419",
            "telephone_number": "908-722-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERGIS",
        "first_name": "MARIAM",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03408800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.