Michele S Cushing-Hennessy, RPH

Individual provider Active NPI Pharmacist · Park Ridge, NJ

NPI 1396315917 · NPPES record last updated Jun 26, 2021

Key facts

NPI
1396315917
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
28RIO2384900 (NJ)
Practice address
40 Park Ave Ste 5
Park Ridge, NJ 07656-1455
Phone
(201) 554-2200
NPI assigned
Jun 26, 2021
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RIO2384900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Blooming Health LLC Current
since Jul 4, 2021
Accepting new patients
Blooming Health LLC Current
since Sep 23, 2021
Accepting new patients

Locations

40 Park Ave
Ste 5
Park Ridge, NJ 07656
Phone (201) 554-2200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RIO2384900 NJ Yes

Addresses

Primary practice location

40 Park Ave Ste 5
Park Ridge, NJ 07656-1455

Mailing address

40 Park Ave
Park Ridge, NJ 07656-1454
Phone (201) 230-5010

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://www.parkridgepharmacy.com/ Direct

Other providers in Park Ridge, NJ

All providers in Park Ridge, NJ · Pharmacist in New Jersey

Sources for this page

Verify at the official NPI Registry.