Individual provider Active NPI

Michael Mangulabnan

  • Pharmacist
  • Brooklawn, NJ
National Provider Identifier
1932509734
Registry record updated Aug 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03645900 Issued in NJ
Practice address
702 Browning LN
Brooklawn, NJ 08030-2645
Phone
(856) 456-7141
NPI assigned
Aug 28, 2014
Last updated
Aug 28, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03645900 NJ Primary

Addresses

Primary practice location

702 Browning LN
Brooklawn, NJ 08030-2645

Mailing address

1013 Woodhill CT
Williamstown, NJ 08094-9142

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

LicenseStateTypeSpecialty
28RI03645900NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrift Drug Inc Past Accepting new patients
Thrift Drug Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1932509734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 WOODHILL CT",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080949142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 BROWNING LN",
            "city": "BROOKLAWN",
            "state": "NJ",
            "postal_code": "080302645",
            "telephone_number": "856-456-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGULABNAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03645900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.