Individual provider Active NPI

Marian Thomas-Lane, RPH

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1609191063
Registry record updated Mar 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
040782 Issued in NY
Practice address
2702 Pearsall Ave
Bronx, NY 10469-5323
Phone
(646) 554-0678
NPI assigned
Mar 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 040782 NY Primary

Addresses

Primary practice location

2702 Pearsall Ave
Bronx, NY 10469-5323

Mailing address

5700 Mosholu Ave
Bronx, NY 10471-2214
Phone (646) 554-0678

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
040782NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269820800000",
    "number": "1609191063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 MOSHOLU AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712214",
            "telephone_number": "646-554-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 PEARSALL AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695323",
            "telephone_number": "646-554-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-LANE",
        "first_name": "MARIAN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-29",
        "last_updated": "2010-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "040782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; 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.