Nicole Manfria, RPH, PHARMD

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

PCT.0011042 Issued in CT

Practice address

194 Broad St Ste B
Bloomfield, NJ 07003-4394

Phone

(973) 429-0444

Fax

(973) 429-0440

NPI assigned

Dec 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

Practice roles

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.

• Icare Pharmacy

  • Specialty Pharmacy
  • Bloomfield, NJ
  • NPI 1720401722
  NPD (past)

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1043970072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 BROAD ST STE B",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034394",
            "telephone_number": "973-429-0444",
            "fax_number": "973-429-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 BROAD ST STE B",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034394",
            "telephone_number": "973-429-0444",
            "fax_number": "973-429-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFRIA",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "RPH, PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NJ",
            "license": "28RI03406300",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CT",
            "license": "PCT.0011042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "PCT.0011042",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACIST LICENSE",
            "identifier": "28RI03406300",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ICARE",
            "affiliation": "Y",
            "affiliationName": "iCare pharmacy",
            "address_1": "194 Broad St Ste B",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070034394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacotherapy Pharmacist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Pharmacotherapy Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.