Individual provider Active NPI

Kerolos Antonious

  • Pharmacist
  • New Brunswick, NJ
National Provider Identifier
1043970783
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04225300 Issued in NJ
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 246-1745
NPI assigned
Dec 21, 2021
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04225300 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 246-1745

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

State licenses

LicenseStateTypeSpecialty
28RI04225300NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1640044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1043970783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-246-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-246-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIOUS",
        "first_name": "KEROLOS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-21",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04225300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.