Individual provider Active NPI

Maabo Kludze-Forson, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • New York, NY
National Provider Identifier
1669763025
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
051853 Issued in NY
Practice address
555 W 57TH St
New York, NY 10019-2925
Phone
(212) 506-5498
NPI assigned
Apr 20, 2011
Last updated
Aug 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03111100 NJ
Pharmacist 183500000X 051853 NY
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 051853 NY Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 28RI03111100 NJ

Addresses

Primary practice location

555 W 57TH St
New York, NY 10019-2925

Mailing address

555 W 57TH St
New York, NY 10019-2925
Phone (212) 506-5498

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03111100NJMDPharmacist
051853NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1669763025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192925",
            "telephone_number": "212-506-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W 57TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192925",
            "telephone_number": "212-506-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUDZE-FORSON",
        "first_name": "MAABO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03111100",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051853",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NY",
            "license": "051853",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RI03111100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.