Individual provider Active NPI

Cicero Tanalgo Coloma, RPH

  • Pharmacist
  • Bergenfield, NJ
National Provider Identifier
1861753246
Registry record updated Jun 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042786 Issued in NY
Practice address
221 Hickory Ave
Bergenfield, NJ 07621-1844
Phone
(201) 385-3103
NPI assigned
Jun 2, 2012
Last updated
Jun 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 042786 NY Primary

Addresses

Primary practice location

221 Hickory Ave
Bergenfield, NJ 07621-1844

Mailing address

221 Hickory Ave
Bergenfield, NJ 07621-1844
Phone (201) 385-3103

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

LicenseStateTypeSpecialty
042786NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1338595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338595200000",
    "number": "1861753246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 HICKORY AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211844",
            "telephone_number": "201-385-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HICKORY AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211844",
            "telephone_number": "201-385-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLOMA",
        "first_name": "CICERO",
        "middle_name": "TANALGO",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-02",
        "last_updated": "2012-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bergenfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.