Active NPI
Alda Reverendo, RPH
- Pharmacist
- Kearny, NJ
National Provider Identifier
1619147857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02215000
- Practice address
- 145 Passaic Ave
Kearny, NJ 07032-1105 - Phone
- (201) 991-4409
- Fax
- (201) 955-1117
- NPI assigned
- Mar 4, 2008
- Last updated
- Mar 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02215000 | NJ | Primary |
Addresses
Primary practice location
145 Passaic Ave
Kearny, NJ 07032-1105
Mailing address
145 Passaic Ave
Kearny, NJ 07032-1105
Phone (201) 991-4409
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02215000 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathmark Stores Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1619147857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 PASSAIC AVE",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321105",
"telephone_number": "201-991-4409",
"fax_number": "201-955-1117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 PASSAIC AVE",
"city": "KEARNY",
"state": "NJ",
"postal_code": "070321105",
"telephone_number": "201-991-4409",
"fax_number": "201-955-1117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REVERENDO",
"first_name": "ALDA",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02215000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kearny, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.