Active NPI
John Henry Panko
- Pharmacist
- Little Silver, NJ
National Provider Identifier
1053694612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RI20661
- Practice address
- 531 Prospect Ave
Little Silver, NJ 07739-1439 - Phone
- (732) 219-7021
- NPI assigned
- Sep 21, 2011
- Last updated
- Sep 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RI20661 | NJ | Primary |
Addresses
Primary practice location
531 Prospect Ave
Little Silver, NJ 07739-1439
Mailing address
27 Waters LN
Millstone Township, NJ 08535-8170
Phone (732) 446-5758
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
| License | State | Type | Specialty |
|---|---|---|---|
| RI20661 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co, 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1053694612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 WATERS LN",
"city": "MILLSTONE TOWNSHIP",
"state": "NJ",
"postal_code": "085358170",
"telephone_number": "732-446-5758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 PROSPECT AVE",
"city": "LITTLE SILVER",
"state": "NJ",
"postal_code": "077391439",
"telephone_number": "732-219-7021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANKO",
"first_name": "JOHN",
"middle_name": "HENRY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-21",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "RI20661",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Silver, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.