Individual provider Active NPI

Laura Viscovic, RPH

  • Pharmacist
  • Hackensack, NJ
National Provider Identifier
1396073458
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02093300 Issued in NJ
Practice address
630 Main St
Hackensack, NJ 07601-5913
Phone
(201) 678-0569
NPI assigned
Dec 1, 2009
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02093300 NJ Primary
Pharmacist 183500000X 20052422 NY

Addresses

Primary practice location

630 Main St
Hackensack, NJ 07601-5913

Mailing address

630 Main St
Hackensack, NJ 07601-5913
Phone (201) 678-0569

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
28RI02093300NJMDPharmacist
20052422NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1396073458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015913",
            "telephone_number": "201-678-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015913",
            "telephone_number": "201-678-0569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCOVIC",
        "first_name": "LAURA",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02093300",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "20052422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.