St Peter Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28RS00732800 Issued in NJ

Legal business name

ST PETER PHARMACY

Doing business as

ST PETER PHARMACY

Practice address

15-17 Ropes PL
#106
Newark, NJ 07107-4803

Phone

(862) 240-9311

Fax

(862) 240-9310

NPI assigned

Apr 18, 2014

Organization subpart

No

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

Authorized official

Name

Peter MassakNPI 1609729011

Title

Member

Phone

(862) 240-9311

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ST PETER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Massak

  • Community/Retail Pharmacy
  • Newark, NJ
  • NPI 1609729011
  NPD Authorized official

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1952721847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15-17 ROPES PL",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071074803",
            "telephone_number": "862-240-9311",
            "fax_number": "862-240-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15-17 ROPES PL",
            "address_2": "#106",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071074803",
            "telephone_number": "862-240-9311",
            "fax_number": "862-240-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-18",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "MASSAK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "862-240-9311"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00732800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST PETER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sushama Srivastava
• Allen Judah Srulowitz, M.D.
• Carolyn Rose St Hilaire, WHNP-BC
• St Michael Infectious Disease Associates
• St Michaels Cardiology Associates
• Dustin St. George, MD
• St. James Social Services Corp.
• St. Therese Ministry and Sabbath School
• St. Timothy'S Group Home for Boys
• Vasley St.Juste

• Community/Retail Pharmacy in Newark, NJ
• Providers in Newark, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.