Individual provider Active NPI

Paul Mina, PHARMACIST

  • Pharmacist
  • Jackson Heights, NY
National Provider Identifier
1669743043
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
055819-1 Issued in NY
Practice address
34-54 Junction BLV
Jackson Heights, NY 11372
Phone
(718) 565-1005
Fax
(718) 565-1004
NPI assigned
Jan 18, 2012
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 055819-1 NY Primary

Addresses

Primary practice location

34-54 Junction BLV
Jackson Heights, NY 11372

Mailing address

427 Danbury LN
East Brunswick, NJ 08816-5116
Phone (732) 613-1459

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
055819-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Express Pharmacy Corp 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": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1669743043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 DANBURY LN",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165116",
            "telephone_number": "732-613-1459",
            "fax_number": "732-613-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34-54 JUNCTION BLV",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "11372",
            "telephone_number": "718-565-1005",
            "fax_number": "718-565-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINA",
        "first_name": "PAUL",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055819-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.