Active NPI
Mark Mierzwa, PHARMD
- Psychiatric Pharmacist
- Kaneohe, HI
National Provider Identifier
1104366020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- PH 2132
- Practice address
- 45-710 Keaahala Rd
Building G - Pharmacy
Kaneohe, HI 96744-3528 - Phone
- (808) 236-8350
- Fax
- (808) 247-2037
- NPI assigned
- Feb 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | PH 2132 | HI | Primary |
| Psychiatric Pharmacist | 1835P1300X | 28RI02758600 | NJ |
Addresses
Primary practice location
45-710 Keaahala Rd
Building G - Pharmacy
Kaneohe, HI 96744-3528
Mailing address
45-710 Keaahala Rd
Building G - Pharmacy
Kaneohe, HI 96744-3528
Phone (808) 236-8350
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 |
|---|---|---|---|
| PH 2132 | HI | MD | Psychiatric Pharmacist |
| 28RI02758600 | NJ | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487894400000",
"number": "1104366020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45-710 KEAAHALA RD",
"address_2": "BUILDING G - PHARMACY",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967443528",
"telephone_number": "808-236-8350",
"fax_number": "808-247-2037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45-710 KEAAHALA RD",
"address_2": "BUILDING G - PHARMACY",
"city": "KANEOHE",
"state": "HI",
"postal_code": "967443528",
"telephone_number": "808-236-8350",
"fax_number": "808-247-2037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIERZWA",
"first_name": "MARK",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-24",
"last_updated": "2017-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "HI",
"license": "PH 2132",
"primary": true
},
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "NJ",
"license": "28RI02758600",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaneohe, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.