Active NPI
Phyllis Anne Luciani, R.PH.
- Pharmacist
- Clementon, NJ
National Provider Identifier
1710219936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI01983700
- Practice address
- 1468 Blackwood Clementon Rd
Clementon, NJ 08021-5701 - Phone
- (856) 627-0111
- Fax
- (856) 627-0612
- NPI assigned
- Feb 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI01983700 | NJ | Primary |
| Pharmacist | 183500000X | 115303 | MN |
Addresses
Primary practice location
1468 Blackwood Clementon Rd
Clementon, NJ 08021-5701
Mailing address
817B Country Club Pkwy
Mount Laurel, NJ 08054-2714
Phone (612) 414-9639
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115303 | MN | MD | Pharmacist |
| 28RI01983700 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265932800000",
"number": "1710219936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817B COUNTRY CLUB PKWY",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080542714",
"telephone_number": "612-414-9639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1468 BLACKWOOD CLEMENTON RD",
"city": "CLEMENTON",
"state": "NJ",
"postal_code": "080215701",
"telephone_number": "856-627-0111",
"fax_number": "856-627-0612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCIANI",
"first_name": "PHYLLIS",
"middle_name": "ANNE",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-12",
"last_updated": "2010-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI01983700",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "115303",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clementon, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.