Individual provider Active NPI

Marc A Gaballa

  • Pharmacist
  • North Brunswick, NJ
National Provider Identifier
1508409723
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04061100 Issued in NJ
Practice address
841 Georges Rd
North Brunswick, NJ 08902-3359
Phone
(732) 545-9487
NPI assigned
Oct 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04061100 NJ Primary

Addresses

Primary practice location

841 Georges Rd
North Brunswick, NJ 08902-3359

Mailing address

23 Fairfield Rd
East Brunswick, NJ 08816-3647
Phone (732) 556-7009

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

LicenseStateTypeSpecialty
28RI04061100NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Brunswick Pharmacy Inc Current Accepting new patients
North Brunswick Pharmacy Current Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1508409723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FAIRFIELD RD",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163647",
            "telephone_number": "732-556-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 GEORGES RD",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023359",
            "telephone_number": "732-545-9487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABALLA",
        "first_name": "MARC",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04061100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.