Sandrine Claire Mbouyo, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI04159700 Issued in NJ

Practice address

810 Springfield Ave
Irvington, NJ 07111-3616

Phone

(862) 236-1348

Fax

(862) 236-1349

NPI assigned

May 31, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Irvington, NJ
  • NPI 1316482078
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1639430200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113616",
            "telephone_number": "862-236-1348",
            "fax_number": "862-236-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113616",
            "telephone_number": "862-236-1348",
            "fax_number": "862-236-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MBOUYO",
        "first_name": "SANDRINE",
        "middle_name": "CLAIRE",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04159700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sandrine.mbouyo@walgreens.com",
            "affiliation": "N",
            "address_1": "810 Springfield Ave",
            "city": "Irvington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071113616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "sandrine.mbouyo@walgreens.com",
            "affiliation": "N",
            "address_1": "810 Springfield Ave",
            "city": "Irvington",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071113616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth K Mammen-Prasad, MD
• Maple Gardens Pharmacy
• Jeannie Martinez-Gonzales, RT(R)
• Harvey G Masor, MD
• Mat/CH Care Service Inc.
• MC Properties Associates LLC
• Jerrilynn McCray, LSW
• Kareem M McKenzie, LAC
• Merciful Property Group
• Merkaba MTS, LLC.

• Pharmacist in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.