Active NPI
Evan Reinecke
- Pharmacist
- Fairview, NJ
National Provider Identifier
1154599421
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02604600
- Practice address
- 425 Anderson Ave
Fairview, NJ 07022-1103 - Phone
- (201) 941-7170
- NPI assigned
- Feb 20, 2008
- Last updated
- Feb 20, 2008
- Sex
- Male
- Sole proprietor
- No
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 | 28RI02604600 | NJ | Primary |
Addresses
Primary practice location
425 Anderson Ave
Fairview, NJ 07022-1103
Mailing address
35-07 Garden View Ter
Fair Lawn, NJ 07410-4338
Phone (201) 794-1293
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28RI02604600 | Other | NJ | PHARMACY |
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 |
|---|---|---|---|
| 28RI02604600 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Atlantic & Pacific Tea Company Inc | Past | Accepting new patients | |
| Great Atlantic & Pacific Tea Company Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1154599421",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35-07 GARDEN VIEW TER",
"city": "FAIR LAWN",
"state": "NJ",
"postal_code": "074104338",
"telephone_number": "201-794-1293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 ANDERSON AVE",
"city": "FAIRVIEW",
"state": "NJ",
"postal_code": "070221103",
"telephone_number": "201-941-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REINECKE",
"first_name": "EVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-20",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02604600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY",
"identifier": "28RI02604600",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairview, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.