Individual provider Active NPI

Brian Thomas Mulroy, RPH

  • Pharmacist
  • Ridgewood, NJ
National Provider Identifier
1588765978
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01656000 Issued in NJ
Practice address
345 Jefferson St
Ridgewood, NJ 07450-2209
Phone
(201) 445-0799
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01656000 NJ Primary

Addresses

Primary practice location

345 Jefferson St
Ridgewood, NJ 07450-2209

Mailing address

345 Jefferson St
Ridgewood, NJ 07450-2209
Phone (201) 445-0799

Other identifiers 1

IdentifierTypeStateIssuer
28RI01656000OtherNJPHARMACIST LICSENS

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI01656000NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588765978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 JEFFERSON ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502209",
            "telephone_number": "201-445-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 JEFFERSON ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502209",
            "telephone_number": "201-445-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULROY",
        "first_name": "BRIAN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01656000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICSENS",
            "identifier": "28RI01656000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.