Active NPI
Mostafa S Elgibaly
- Pharmacist
- West Long Branch, NJ
National Provider Identifier
1124400288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03706700
- Practice address
- 216 Route 36
Walgreens Store 5201
West Long Branch, NJ 07764-1305 - Phone
- (732) 728-2283
- NPI assigned
- Jun 25, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03706700 | NJ | Primary |
Addresses
Primary practice location
216 Route 36
Walgreens Store 5201
West Long Branch, NJ 07764-1305
Mailing address
217 Garfield Ave
Avon by the Sea, NJ 07717-1207
Phone (848) 223-2155
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 |
|---|---|---|---|
| 28RI03706700 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | 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.
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- Longview, TX
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435190400000",
"number": "1124400288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 GARFIELD AVE",
"city": "AVON BY THE SEA",
"state": "NJ",
"postal_code": "077171207",
"telephone_number": "848-223-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 ROUTE 36",
"address_2": "WALGREENS STORE 5201",
"city": "WEST LONG BRANCH",
"state": "NJ",
"postal_code": "077641305",
"telephone_number": "732-728-2283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELGIBALY",
"first_name": "MOSTAFA",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-25",
"last_updated": "2015-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03706700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Long Branch, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.