Individual provider Active NPI

Gary Bryant Angelo, RPH

  • Pharmacist
  • Toms River, NJ
National Provider Identifier
1336218858
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01287400 Issued in NJ
Practice address
1824 Hooper Ave
Toms River, NJ 08753-8163
Phone
(732) 255-3121
Fax
(732) 255-3249
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01287400 NJ Primary

Addresses

Primary practice location

1824 Hooper Ave
Toms River, NJ 08753-8163

Mailing address

1824 Hooper Ave
Toms River, NJ 08753-8163
Phone (732) 255-3121

Other identifiers 1

IdentifierTypeStateIssuer
28RI01287400OtherNJPHARMACY LICENSE REGISTRA

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
28RI01287400NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336218858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538163",
            "telephone_number": "732-255-3121",
            "fax_number": "732-255-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 HOOPER AVE",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538163",
            "telephone_number": "732-255-3121",
            "fax_number": "732-255-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "GARY",
        "middle_name": "BRYANT",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01287400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE REGISTRA",
            "identifier": "28RI01287400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.