Individual provider Active NPI

Thanh Phuoc Tran

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1215256573
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03060500 Issued in NJ
Practice address
1212 Summit Ave.
Jersey City, NJ 07307
Phone
(201) 876-0107
Fax
(201) 876-0142
NPI assigned
May 26, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03060500 NJ Primary

Addresses

Primary practice location

1212 Summit Ave.
Jersey City, NJ 07307

Mailing address

1212 Summit Avenue
Jersey City, NJ 07307
Phone (201) 876-0107

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
28RI03060500NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1215256573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 SUMMIT AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07307",
            "telephone_number": "201-876-0107",
            "fax_number": "201-876-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 SUMMIT AVE.",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07307",
            "telephone_number": "201-876-0107",
            "fax_number": "201-876-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "THANH",
        "middle_name": "PHUOC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03060500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.