Active NPI
Michelle J Lanza
- Pharmacist
- Fairfield, NJ
National Provider Identifier
1104429521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04075200
- Practice address
- 632 US Highway 46
Fairfield, NJ 07004-1581 - Phone
- (973) 396-0070
- NPI assigned
- Nov 18, 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 | 28RI04075200 | NJ | Primary |
Addresses
Primary practice location
632 US Highway 46
Fairfield, NJ 07004-1581
Mailing address
213 1St St
East Northport, NY 11731-3509
Phone (631) 838-6872
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 |
|---|---|---|---|
| 28RI04075200 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Winston Salem, NC
- NPI 1699797258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1104429521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 1ST ST",
"city": "EAST NORTHPORT",
"state": "NY",
"postal_code": "117313509",
"telephone_number": "631-838-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "632 US HIGHWAY 46",
"city": "FAIRFIELD",
"state": "NJ",
"postal_code": "070041581",
"telephone_number": "973-396-0070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANZA",
"first_name": "MICHELLE",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04075200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.