Katherine Iliadis, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI02085900 Issued in NJ

Practice address

219 E Main St
Moorestown, NJ 08057-2905

Phone

(856) 914-2021

NPI assigned

Mar 6, 2021

Last updated

Mar 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1548855075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BROOKS RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573858",
            "telephone_number": "856-722-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E MAIN ST",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572905",
            "telephone_number": "856-914-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIADIS",
        "first_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02085900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "28RI02085900",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "8562665957",
            "affiliation": "N",
            "endpointDescription": "cell phone",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "40 Brooks Rd",
            "city": "Moorestown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080573858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.