Mary Louise Wagner, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

28RJ10156 Issued in NJ

Practice address

18 Centre Dr
Monroe TWP, NJ 08831-1501

Phone

(732) 439-0282

NPI assigned

Dec 2, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1073339388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 DOROTHY LN",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088502109",
            "telephone_number": "732-439-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 CENTRE DR",
            "city": "MONROE TWP",
            "state": "NJ",
            "postal_code": "088311501",
            "telephone_number": "732-439-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Dorothy Ln",
            "address_purpose": "LOCATION",
            "city": "Milltown",
            "state": "NJ",
            "postal_code": "088502109",
            "country_code": "US",
            "telephone_number": "732-439-0282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NJ",
            "license": "A-3976380",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "NJ",
            "license": "28RJ10156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherryl L Thomas, MD
• Madison Jade Tillem, OTR/L
• Titan Health Partners LLC
• Township of Monroe
• Melinda Sorochi Ude, DPT
• Robert Wilson
• Loretta J Wojciechowski, DC
• Teriza F Younan

• Ambulatory Care Pharmacist in Monroe TWP, NJ
• Providers in Monroe TWP, NJ by specialty
• Ambulatory Care Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.