Individual provider Active NPI

Marie Dominique Importante Sia, PHARMD, RPH

  • Pharmacist
  • Ledgewood, NJ
National Provider Identifier
1679176044
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04018400 Issued in NJ
Practice address
1105 US Highway 46
Ledgewood, NJ 07852-9748
Phone
(973) 927-4662
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH237986 MA
Pharmacist 183500000X 28RI04018400 NJ Primary

Addresses

Primary practice location

1105 US Highway 46
Ledgewood, NJ 07852-9748

Mailing address

1105 US Highway 46
Ledgewood, NJ 07852-9748
Phone (973) 927-4662

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, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH237986MAMDPharmacist
28RI04018400NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1679176044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 US HIGHWAY 46",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529748",
            "telephone_number": "973-927-4662",
            "fax_number": "973-927-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 US HIGHWAY 46",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529748",
            "telephone_number": "973-927-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIA",
        "first_name": "MARIE DOMINIQUE",
        "middle_name": "IMPORTANTE",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH237986",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04018400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ledgewood, NJ

Sources for this page

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