Active NPI
Mary Nizar Alkouraan
- Pharmacist
- West New York, NJ
National Provider Identifier
1104282649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03763900
- Practice address
- 5706 Bergenline Ave
West New York, NJ 07093-1230 - Phone
- (201) 869-8054
- NPI assigned
- Jan 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 28RI03763900 | NJ | Primary |
Addresses
Primary practice location
5706 Bergenline Ave
West New York, NJ 07093-1230
Mailing address
5706 Bergenline Ave
West New York, NJ 07093-1230
Phone (201) 869-8054
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 |
|---|---|---|---|
| 28RI03763900 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674777600000",
"number": "1104282649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5706 BERGENLINE AVE",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070931230",
"telephone_number": "201-869-8054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5706 BERGENLINE AVE",
"city": "WEST NEW YORK",
"state": "NJ",
"postal_code": "070931230",
"telephone_number": "201-869-8054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALKOURAAN",
"first_name": "MARY",
"middle_name": "NIZAR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-13",
"last_updated": "2023-01-27",
"certification_date": "2023-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03763900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West New York, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.