Active NPI
Mousumi Liza Sultana, PHARMD
- Pharmacist
- Sicklerville, NJ
National Provider Identifier
1093311029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RIO3969400
- Practice address
- 589 Berlin Cross Keys Rd
Sicklerville, NJ 08081-9506 - Phone
- (856) 629-6453
- Fax
- (856) 262-9174
- NPI assigned
- Dec 6, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RIO3969400 | NJ | Primary |
Addresses
Primary practice location
589 Berlin Cross Keys Rd
Sicklerville, NJ 08081-9506
Mailing address
589 Berlin Cross Keys Rd
Sicklerville, NJ 08081-9506
Phone (856) 629-6453
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 |
|---|---|---|---|
| 28RIO3969400 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607212800000",
"number": "1093311029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "589 BERLIN CROSS KEYS RD",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080819506",
"telephone_number": "856-629-6453",
"fax_number": "856-262-9174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "589 BERLIN CROSS KEYS RD",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080819506",
"telephone_number": "856-629-6453",
"fax_number": "856-262-9174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULTANA",
"first_name": "MOUSUMI",
"middle_name": "LIZA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-06",
"last_updated": "2020-12-06",
"certification_date": "2020-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RIO3969400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sicklerville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.