Active NPI
Michael Wahba
- Pharmacist
- Bayonne, NJ
National Provider Identifier
1841701703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03875400
- Practice address
- 1225 Kennedy Blvd Apt 9E
Bayonne, NJ 07002-2255 - Phone
- (347) 653-7758
- NPI assigned
- Oct 18, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03875400 | NJ | Primary |
Addresses
Primary practice location
1225 Kennedy Blvd Apt 9E
Bayonne, NJ 07002-2255
Mailing address
1225 Kennedy Blvd Apt 9E
Bayonne, NJ 07002-2255
Phone (347) 653-7758
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03875400 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662076800000",
"number": "1841701703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 KENNEDY BLVD APT 9E",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070022255",
"telephone_number": "347-653-7758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 KENNEDY BLVD APT 9E",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070022255",
"telephone_number": "347-653-7758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHBA",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-18",
"last_updated": "2022-09-02",
"certification_date": "2022-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03875400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.