Individual provider Active NPI

David Chiu, PHARMACIST

  • Pharmacist
  • North Bergen, NJ
National Provider Identifier
1619155843
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02860000 Issued in NJ
Practice address
1417 Kennedy Blvd
North Bergen, NJ 07047-6307
Phone
(201) 864-5617
Fax
(201) 864-5623
NPI assigned
Feb 11, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02860000 NJ Primary
Pharmacist 183500000X 0499881 NY

Addresses

Primary practice location

1417 Kennedy Blvd
North Bergen, NJ 07047-6307

Mailing address

1417 Kennedy Blvd
North Bergen, NJ 07047-6307
Phone (201) 864-5617

Other identifiers 2

IdentifierTypeStateIssuer
28RI02860000OtherNJNJ STATE LICENSE
0499881OtherNYNY STATE LICENSE

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

State licenses

LicenseStateTypeSpecialty
28RI02860000NJMDPharmacist
0499881NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1619155843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476307",
            "telephone_number": "201-864-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070476307",
            "telephone_number": "201-864-5617",
            "fax_number": "201-864-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIU",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02860000",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0499881",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE LICENSE",
            "identifier": "28RI02860000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE",
            "identifier": "0499881",
            "state": "NY"
        }
    ],
    "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 Jun 9, 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.

Verify at the official NPI Registry.