Individual provider Active NPI

Mirla Jukic, RPH

  • Pharmacist
  • Elizabeth, NJ
National Provider Identifier
1962770784
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02791800 Issued in NJ
Practice address
600 Newark Ave
Elizabeth, NJ 07208-3539
Phone
(908) 353-7443
NPI assigned
Dec 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02791800 NJ Primary

Addresses

Primary practice location

600 Newark Ave
Elizabeth, NJ 07208-3539

Mailing address

600 Newark Ave
Elizabeth, NJ 07208-3539
Phone (908) 353-7443

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
28RI02791800NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323216000000",
    "number": "1962770784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083539",
            "telephone_number": "908-353-7443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083539",
            "telephone_number": "908-353-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUKIC",
        "first_name": "MIRLA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02791800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.