Active NPI
Victoriano Diaz, PHARMD
- Pharmacist
- Jersey City, NJ
National Provider Identifier
1508320144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03945000
- Practice address
- 239 Old Bergen Rd
Jersey City, NJ 07305-2620 - Phone
- (201) 434-8062
- Fax
- (201) 434-7596
- NPI assigned
- Jan 28, 2019
- Sex
- Male
- 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 | 28RI03945000 | NJ | Primary |
Addresses
Primary practice location
239 Old Bergen Rd
Jersey City, NJ 07305-2620
Mailing address
239 Old Bergen Rd
Jersey City, NJ 07305-2620
Phone (201) 434-8062
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03945000 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555632000000",
"number": "1508320144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "239 OLD BERGEN RD",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073052620",
"telephone_number": "201-434-8062",
"fax_number": "201-434-7596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "239 OLD BERGEN RD",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073052620",
"telephone_number": "201-434-8062",
"fax_number": "201-434-7596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIAZ",
"first_name": "VICTORIANO",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-28",
"last_updated": "2019-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03945000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.