Individual provider Active NPI

Maxine Luciano

  • Pharmacy Technician
  • Bergenfield, NJ
National Provider Identifier
1154021186
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacy TechnicianTaxonomy code 183700000X
License
28RW02246100 Issued in NJ
Practice address
10 Portland Ave
Bergenfield, NJ 07621-2305
Phone
(201) 384-2789
NPI assigned
Mar 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 28RW02246100 NJ Primary

Addresses

Primary practice location

10 Portland Ave
Bergenfield, NJ 07621-2305

Mailing address

10 Portland Ave
Bergenfield, NJ 07621-2305
Phone (201) 384-2789

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
28RW02246100NJMDPharmacy Technician

NPI Registry JSON

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1154021186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PORTLAND AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212305",
            "telephone_number": "201-384-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PORTLAND AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212305",
            "telephone_number": "201-384-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIANO",
        "first_name": "MAXINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "NJ",
            "license": "28RW02246100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.