Individual provider Active NPI

Emad Youssef Rezk

  • Pharmacist
  • Bayonne, NJ
National Provider Identifier
1144531633
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02766100 Issued in NJ
Practice address
471 Broadway
Bayonne, NJ 07002-3622
Phone
(201) 339-8181
Fax
(201) 339-5786
NPI assigned
Jun 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02766100 NJ Primary

Addresses

Primary practice location

471 Broadway
Bayonne, NJ 07002-3622

Mailing address

471 Broadway
Bayonne, NJ 07002-3622
Phone (201) 339-8181

Other identifiers 1

IdentifierTypeStateIssuer
4298209MedicaidNJ

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

LicenseStateTypeSpecialty
28RI02766100NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1144531633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023622",
            "telephone_number": "201-339-8181",
            "fax_number": "201-339-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023622",
            "telephone_number": "201-339-8181",
            "fax_number": "201-339-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZK",
        "first_name": "EMAD",
        "middle_name": "YOUSSEF",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02766100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4298209",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.