Pathmark Stores Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

RS003664 Issued in NJ

Legal business name

PATHMARK STORES INC

Doing business as

Pathmark Pharmacy

Practice address

242 Lincoln Blvd.
Middlesex, NJ 08846-2305

Phone

(732) 356-0440

Fax

(732) 356-5349

NPI assigned

Sep 20, 2006

Last updated

Jan 27, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

THE GREAT ATLANTIC & PACIFIC TEA COMPANYAs reported in NPPES

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

Authorized official

Name

Susan D Kijowski

Title

Pharmacy Specialist

Phone

(201) 571-8326

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PATHMARK PHARMACY Doing business as

Part of

The Great Atlantic and

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Great Atlantic & Pacific Tea Company Inc

  dba A & P Pharmacy

  • Pharmacy
  • Allendale, NJ
  • NPI 1962427526

  Member Of

  NPD member

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1184721946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARAGON DR",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451718",
            "telephone_number": "201-573-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 LINCOLN BLVD.",
            "city": "MIDDLESEX",
            "state": "NJ",
            "postal_code": "088462305",
            "telephone_number": "732-356-0440",
            "fax_number": "732-356-5349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHMARK STORES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREAT ATLANTIC & PACIFIC TEA COMPANY",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": "RS28003664",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "RS003664",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3127025",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4363604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHMARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jayesh Pandejee
• Chandni Patel, LCSW, LCADC
• Jay Patel
• Nirav Patel, PHARM D
• Unnati S Patel, DC
• Karen Frances Perko
• Jessica Lynn Perlaza, LCSW
• Michelle Perry-Handler, PT
• Lisa A. Perry, LCSW
• Precious Hands Healthcare LLC

• Pharmacy in Middlesex, NJ
• Providers in Middlesex, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.