Active NPI
Mushmoom Niaz
- Pharmacist
- Newark, NJ
National Provider Identifier
1356907604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04011400
- Practice address
- 654 Mount Prospect Ave
Newark, NJ 07104-3110 - Phone
- (862) 240-9603
- NPI assigned
- May 13, 2019
- Sex
- Female
- 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 | 28RI04011400 | NJ | Primary |
Addresses
Primary practice location
654 Mount Prospect Ave
Newark, NJ 07104-3110
Mailing address
654 Mt Prospect
Newark, NJ 07104
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 |
|---|---|---|---|
| 28RI04011400 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557705600000",
"number": "1356907604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "654 MT PROSPECT",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "654 MOUNT PROSPECT AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071043110",
"telephone_number": "862-240-9603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIAZ",
"first_name": "MUSHMOOM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-13",
"last_updated": "2019-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04011400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.