Individual provider Active NPI

Edith Tortora Micale, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • North Bergen, NJ
National Provider Identifier
1558698324
Registry record updated Nov 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
28R101158600 Issued in NJ
Practice address
7855 Boulevard E
Apartment 7C
North Bergen, NJ 07047-5938
Phone
(201) 662-0623
Fax
(201) 662-0672
NPI assigned
Nov 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 28R101158600 NJ Primary

Addresses

Primary practice location

7855 Boulevard E
Apartment 7C
North Bergen, NJ 07047-5938

Mailing address

7855 Boulevard E
Apartment 7C
North Bergen, NJ 07047-5938
Phone (201) 662-0623

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

LicenseStateTypeSpecialty
28R101158600NJMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1258243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258243200000",
    "number": "1558698324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 BOULEVARD E",
            "address_2": "APARTMENT 7C",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475938",
            "telephone_number": "201-662-0623",
            "fax_number": "201-662-0672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 BOULEVARD E",
            "address_2": "APARTMENT 7C",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475938",
            "telephone_number": "201-662-0623",
            "fax_number": "201-662-0672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICALE",
        "first_name": "EDITH",
        "middle_name": "TORTORA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-15",
        "last_updated": "2009-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28R101158600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2009; 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.