Individual provider Active NPI

Liliana Moon, R.PH.

  • Pharmacist
  • West Orange, NJ
National Provider Identifier
1295916799
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03417800 Issued in NJ
Practice address
265 Prospect Ave
West Orange, NJ 07052-4205
Phone
(973) 243-7008
NPI assigned
Nov 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048678 NY
Pharmacist 183500000X 28RJ06106 NJ
Pharmacist 183500000X 28RI03417800 NJ Primary

Addresses

Primary practice location

265 Prospect Ave
West Orange, NJ 07052-4205

Mailing address

32 Old Farm Rd
Berkeley Heights, NJ 07922-2442
Phone (917) 523-0703

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03417800NJMDPharmacist
28RJ06106NJMDPharmacist
048678NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey CVS Pharmacy LLC PastSince Oct 15, 2023 Accepting new patients
Rite Aid of New York Inc Past Accepting new patients
New Jersey CVS Pharmacy LLC PastSince Oct 15, 2023 Accepting new patients
Rite Aid of New York Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1295916799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 OLD FARM RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222442",
            "telephone_number": "917-523-0703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 PROSPECT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524205",
            "telephone_number": "973-243-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "LILIANA",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048678",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RJ06106",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03417800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.