Active NPI
Randy N. Shreck, PHARMACIST
- Pharmacist
- Fort Lee, NJ
National Provider Identifier
1407009087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RI01730300
- Practice address
- 810 Abbott Blvd
Fort Lee, NJ 07024 - Phone
- (201) 224-4700
- Fax
- (201) 224-4670
- NPI assigned
- Oct 28, 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 | RI01730300 | NJ | Primary |
Addresses
Primary practice location
810 Abbott Blvd
Fort Lee, NJ 07024
Mailing address
810 Abbott Blvd
Fort Lee, NJ 07024
Phone (201) 224-4700
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 |
|---|---|---|---|
| RI01730300 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1407009087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 ABBOTT BLVD",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "07024",
"telephone_number": "201-224-4700",
"fax_number": "201-224-4670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 ABBOTT BLVD",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "07024",
"telephone_number": "201-224-4700",
"fax_number": "201-224-4670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRECK",
"first_name": "RANDY",
"middle_name": "N.",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-28",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "RI01730300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.