Individual provider Active NPI

Malav D Kanuga

  • Pharmacist
  • Jackson, NJ
National Provider Identifier
1174035489
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03131900 Issued in NJ
Practice address
10 S New Prospect Rd
Jackson, NJ 08527-1645
Phone
(732) 370-4777
Fax
(732) 370-4777
NPI assigned
Oct 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03131900 NJ Primary

Addresses

Primary practice location

10 S New Prospect Rd
Jackson, NJ 08527-1645

Mailing address

31 Potomac Rd
Monmouth Junction, NJ 08852-3081
Phone (732) 668-2835

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
28RI03131900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pharma Plus Pharmacy LLC Current Accepting new patients
Pharma Plus Pharmacy LLC Current Accepting new patients
Mule Road Pharmacy LLC Current Accepting new patients

Locations

10 S New Prospect Rd
Jackson, NJ 08527
Phone (732) 370-4222

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1174035489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 POTOMAC RD",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088523081",
            "telephone_number": "732-668-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S NEW PROSPECT RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271645",
            "telephone_number": "732-370-4777",
            "fax_number": "732-370-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANUGA",
        "first_name": "MALAV",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03131900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; 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.