Active NPI
Jonathan Lau
- Pharmacist
- New York, NY
National Provider Identifier
1245637594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 060176
- Practice address
- 87 Mulberry St
New York, NY 10013-4452 - Phone
- (212) 693-6688
- Fax
- (212) 693-6677
- NPI assigned
- Dec 2, 2014
- Last updated
- Jul 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03674900 | NJ | |
| Pharmacist | 183500000X | 060176 | NY | Primary |
Addresses
Primary practice location
87 Mulberry St
New York, NY 10013-4452
Mailing address
242 Marlton Pike W
Cherry Hill, NJ 08002-3016
Phone (856) 428-0473
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 |
|---|---|---|---|
| 28RI03674900 | NJ | MD | Pharmacist |
| 060176 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of New Jersey Inc | Past | Accepting new patients | |
| Mulberry Pharmacy 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.
-
- Community/Retail Pharmacy
- New York, NY
- NPI 1619411493
-
dba Rite Aid Pharmacy 01661
- Community/Retail Pharmacy
- Jersey City, NJ
- NPI 1467561803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1245637594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 MARLTON PIKE W",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080023016",
"telephone_number": "856-428-0473",
"fax_number": "856-428-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 MULBERRY ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100134452",
"telephone_number": "212-693-6688",
"fax_number": "212-693-6677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAU",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03674900",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "060176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.