Moly Poulose, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NN10644300 Issued in NJ

Practice address

880 River Rd
New Milford, NJ 07646-3097

Phone

(866) 389-2727

Fax

(201) 225-2106

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1932228939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 RIVER RD",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076463097",
            "telephone_number": "866-389-2727",
            "fax_number": "201-225-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 RIVER RD",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076463097",
            "telephone_number": "866-389-2727",
            "fax_number": "201-225-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOSE",
        "first_name": "MOLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "488126",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F333216",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NN10644300",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NO10644300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patient Care Center Corp
• Ruth Mani Philip, PHARMD.
• Nistha Pithava, ABA THERAPIST
• Johnson Anabon Pocdihon, PHYSICAL THERAPIST
• Alexandra Polidoro
• Prevail NJ
• Kevin Ragas
• Levana Rajasingham, OTR/L
• Chad Reiser, PT, MPT
• Rochelle Park Diagnostics

• Family Nurse Practitioner in New Milford, NJ
• Providers in New Milford, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; 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.