Active NPI
Mirza Perez-Martinez
- Pharmacist
- Media, PA
National Provider Identifier
1104301811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP437801
- Practice address
- 208 Hermitage LN
Media, PA 19063-5509 - Phone
- (610) 500-1627
- NPI assigned
- Sep 27, 2018
- Last updated
- Sep 27, 2018
- 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 | RP437801 | PA | Primary |
Addresses
Primary practice location
208 Hermitage LN
Media, PA 19063-5509
Mailing address
208 Hermitage LN
Media, PA 19063-5509
Phone (610) 500-1627
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 |
|---|---|---|---|
| RP437801 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1104301811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 HERMITAGE LN",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635509",
"telephone_number": "610-500-1627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 HERMITAGE LN",
"city": "MEDIA",
"state": "PA",
"postal_code": "190635509",
"telephone_number": "610-500-1627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ-MARTINEZ",
"first_name": "MIRZA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-27",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP437801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.