Active NPI
Raul Lucio Mazon, PHARMACIST
- Pharmacist
- Union City, NJ
National Provider Identifier
1215957121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RI01885200
- Practice address
- 149 48TH Street
Union City, NJ 07087 - Phone
- (201) 864-1809
- Fax
- (201) 864-4077
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | RI01885200 | NJ | Primary |
Addresses
Primary practice location
149 48TH Street
Union City, NJ 07087
Mailing address
510 Homans Ave
Closter, NJ 07624
Phone (201) 750-1122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7919603 | Medicaid | NJ |
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 |
|---|---|---|---|
| RI01885200 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PLH Pharmaco | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pharmacy
- Union City, NJ
- NPI 1023173549
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1215957121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 HOMANS AVE",
"city": "CLOSTER",
"state": "NJ",
"postal_code": "07624",
"telephone_number": "201-750-1122",
"fax_number": "201-864-4077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 48TH STREET",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "07087",
"telephone_number": "201-864-1809",
"fax_number": "201-864-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZON",
"first_name": "RAUL",
"middle_name": "LUCIO",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "RI01885200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7919603",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.