Individual provider Active NPI

Christine Dimaculangan, PHARMD

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1104493675
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03891100 Issued in NJ
Practice address
1825 John F Kennedy Blvd FL 2
Jersey City, NJ 07305-2106
Phone
(201) 204-0004
NPI assigned
Jun 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03891100 NJ Primary

Addresses

Primary practice location

1825 John F Kennedy Blvd FL 2
Jersey City, NJ 07305-2106

Mailing address

1825 John F Kennedy Blvd FL 2
Jersey City, NJ 07305-2106
Phone (201) 204-0004

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL N/A

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

LicenseStateTypeSpecialty
28RI03891100NJMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1104493675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 JOHN F KENNEDY BLVD FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052106",
            "telephone_number": "201-204-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 JOHN F KENNEDY BLVD FL 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073052106",
            "telephone_number": "201-204-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMACULANGAN",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03891100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "1825 John F Kennedy Blvd Fl 2",
            "city": "Jersey City",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "073052106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.