Active NPI
Michael Anthony Scicutella
- Pharmacist
- Newark, NJ
National Provider Identifier
1891489779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI01635000
- Practice address
- 199 Ferry St
Newark, NJ 07105-2711 - Phone
- (973) 589-6387
- NPI assigned
- Jun 5, 2023
- 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 | 28RI01635000 | NJ | Primary |
Addresses
Primary practice location
199 Ferry St
Newark, NJ 07105-2711
Mailing address
PO Box 3322
Fort Lee, NJ 07024-9322
Phone (201) 328-6493
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 |
|---|---|---|---|
| 28RI01635000 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalibat Drug Store | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- Newark, NJ
- NPI 1740349745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1891489779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3322",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070249322",
"telephone_number": "201-328-6493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "199 FERRY ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071052711",
"telephone_number": "973-589-6387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCICUTELLA",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-05",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI01635000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.