Active NPI
Mary Beth Stickel, RPH
- Pharmacist
- Raritan, NJ
National Provider Identifier
1467512210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02279300
- Practice address
- 25 W Somerset St
Raritan, NJ 08869-2027 - Phone
- (908) 722-3800
- Fax
- (908) 725-6825
- NPI assigned
- Dec 11, 2006
- Last updated
- Oct 9, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 28RI02279300 | NJ | Primary |
Addresses
Primary practice location
25 W Somerset St
Raritan, NJ 08869-2027
Mailing address
2251 23Rd St
Boulder, CO 80302-4650
Phone (720) 287-4775
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02279300 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raritan Apothecary LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1467512210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 23RD ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803024650",
"telephone_number": "720-287-4775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 W SOMERSET ST",
"city": "RARITAN",
"state": "NJ",
"postal_code": "088692027",
"telephone_number": "908-722-3800",
"fax_number": "908-725-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STICKEL",
"first_name": "MARY",
"middle_name": "BETH",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02279300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raritan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.