Jefferson Isibor

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI03071500 Issued in NJ

Practice address

99 Beauvoir Ave
Summit, NJ 07901-3533

Phone

(908) 522-5342

NPI assigned

May 27, 2020

Last updated

May 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1659994465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HENNING TER",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078343716",
            "telephone_number": "973-216-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISIBOR",
        "first_name": "JEFFERSON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-27",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03071500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "atlantichealth.org",
            "affiliation": "N",
            "endpointDescription": "Overlook Medical System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "atlantic health system",
            "address_1": "99 Beauvoir Ave",
            "city": "Summit",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "079013533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Investra Corp. (Liss Pharmacy)
• Amanda Frances Iorio
• Deanna Korcha Ippolito
• Keren Lital Isaacs Lebeau, PH.D.
• Amy Lynne Ishak, APRN
• Anthony Iuzzolino, M.D.
• Kristen Allyssa Ivory, NP
• Bhanu Iyer, MD
• Mitchell Jablons, MD
• Nabil Jacir, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; 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.