Individual provider Active NPI

Ewere S Isibor, PHARMD

  • Pharmacist
  • Bridgewater, NJ
National Provider Identifier
1275831067
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03026100 Issued in NJ
Practice address
353 US Highway 202/206
Bridgewater, NJ 08807-2442
Phone
(908) 725-5162
NPI assigned
Mar 3, 2011
Last updated
Mar 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03026100 NJ Primary

Addresses

Primary practice location

353 US Highway 202/206
Bridgewater, NJ 08807-2442

Mailing address

18 Rolling Ridge Dr
Rockaway, NJ 07866-4315
Phone (973) 332-9761

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03026100NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1275831067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ROLLING RIDGE DR",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078664315",
            "telephone_number": "973-332-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 US HIGHWAY 202/206",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072442",
            "telephone_number": "908-725-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIBOR",
        "first_name": "EWERE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03026100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.