Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

RS002954 Issued in NJ

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

Route 440 and Kellogg St
Jersey City, NJ 07305

Phone

(201) 434-1212

Fax

(201) 499-1063

NPI assigned

Sep 26, 2006

Last updated

Sep 29, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC AND PACIFIC TEA CO INCAs reported in NPPES

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

Authorized official

Name

Susan D Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

The Great Atlantic and

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Great Atlantic & Pacific Tea Company Inc

  dba A & P Pharmacy

  • Pharmacy
  • Allendale, NJ
  • NPI 1962427526

  Member Of

  NPD member

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1043311418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700",
            "fax_number": "201-571-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 440 AND KELLOGG ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07305",
            "telephone_number": "201-434-1212",
            "fax_number": "201-499-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC AND PACIFIC TEA CO INC",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS002954",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3102895",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4260503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vinodkumar Patel, MD
• Vipul H Patel, RPH
• Deepankar Raj Pathak
• Hrishi Pathak, PHYSICAL THERAPIST
• Kunal Pathak
• Pathmark Stores Inc (Pathmark Pharmacy)
• Andrea Patrick
• Atiya Malika Patterson
• Simone Cyise Patterson, LPC, LCADC
• Paul Lustiger, DDS PA

• Pharmacy in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.