Active NPI
Max Gruenberg
- Pharmacist
- Fairview, NJ
National Provider Identifier
1326216813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RS00475600
- Practice address
- 425 Anderson Ave
Fairview, NJ 07022-1103 - Phone
- (201) 941-7170
- NPI assigned
- Feb 18, 2008
- Last updated
- Feb 18, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RS00475600 | NJ | Primary |
Addresses
Primary practice location
425 Anderson Ave
Fairview, NJ 07022-1103
Mailing address
258 Undercliff Ave
Edgewater, NJ 07020-1113
Phone (201) 941-1264
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28RS00475600 | Other | NJ | PHARMACY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Atlantic & Pacific Tea Company Inc | Past | Accepting new patients | |
| Great Atlantic & Pacific Tea Company 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203292800000",
"number": "1326216813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 UNDERCLIFF AVE",
"city": "EDGEWATER",
"state": "NJ",
"postal_code": "070201113",
"telephone_number": "201-941-1264"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 ANDERSON AVE",
"city": "FAIRVIEW",
"state": "NJ",
"postal_code": "070221103",
"telephone_number": "201-941-7170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUENBERG",
"first_name": "MAX",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-18",
"last_updated": "2008-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RS00475600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY",
"identifier": "28RS00475600",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairview, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.