Paul Avenoso, PHARMD, BCOP

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

28RI03734100 Issued in NJ

Practice address

160 Pehle Ave Ste 400
Saddle Brook, NJ 07663-5227

Phone

(973) 446-8130

NPI assigned

Feb 1, 2022

Last updated

Feb 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1144973090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 PEHLE AVE STE 400",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635227",
            "telephone_number": "973-446-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 PEHLE AVE STE 400",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635227",
            "telephone_number": "973-446-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENOSO",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCOP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RI03734100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Saddle Brook, NJ
• Providers in Saddle Brook, NJ by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.