Active NPI
Mariel Therese Shull, PHARMD
- Pharmacist
- New York, NY
National Provider Identifier
1063858181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP446102
- Practice address
- One Park Ave
New York, NY 10016 - Phone
- (646) 754-5309
- NPI assigned
- May 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 056643 | NY | |
| Pharmacist | 183500000X | RP446102 | PA | Primary |
Addresses
Primary practice location
One Park Ave
New York, NY 10016
Mailing address
200 Stevens Dr
Philadelphia, PA 19113-1520
Phone (267) 298-2317
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056643 | NY | MD | Pharmacist |
| RP446102 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1063858181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 STEVENS DR",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191131520",
"telephone_number": "267-298-2317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE PARK AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10016",
"telephone_number": "646-754-5309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULL",
"first_name": "MARIEL",
"middle_name": "THERESE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-15",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "056643",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP446102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.