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
- Last updated
- Apr 19, 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 |
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": "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.