Individual provider Active NPI

Nadia Karol Bukacz, RPH

  • Pharmacist
  • Trenton, NJ
National Provider Identifier
1487235115
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02281700 Issued in NJ
Practice address
521 S Broad St
Trenton, NJ 08611-1819
Phone
(609) 858-7560
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02281700 NJ Primary

Addresses

Primary practice location

521 S Broad St
Trenton, NJ 08611-1819

Mailing address

239 Amberfield Dr
Mount Laurel, NJ 08054-5128
Phone (856) 912-3714

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
28RI02281700NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1487235115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 AMBERFIELD DR",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080545128",
            "telephone_number": "856-912-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 S BROAD ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086111819",
            "telephone_number": "609-858-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKACZ",
        "first_name": "NADIA",
        "middle_name": "KAROL",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02281700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.