Alicia Shana Mattson, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI02596800 Issued in NJ

Practice address

335 E Jimmie Leeds Rd
Galloway, NJ 08205-4127

Phone

(609) 748-2449

Fax

(609) 748-0959

NPI assigned

Oct 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286150400000",
    "number": "1972812246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054127",
            "telephone_number": "609-748-2449",
            "fax_number": "609-748-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E JIMMIE LEEDS RD",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054127",
            "telephone_number": "609-748-2449",
            "fax_number": "609-748-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTSON",
        "first_name": "ALICIA",
        "middle_name": "SHANA",
        "name_prefix": "Mrs.",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-04",
        "last_updated": "2010-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02596800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE IMMUNIZATION PROVIDER NUMBER",
            "identifier": "28RJ02336",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "28RI02596800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Mangaro, APN
• Jessica Lynn Manning
• Robert Marsico, PT, ED.D, OCS
• James R Massaro, DC
• Megan Margaret Master, PT, DPT
• Emily Ann Maul, M.S.ED CCC-SLP
• Christine Mayer, LSW
• Bridgette McCabe, M.D.
• Emily Anne McCall, LSW
• Kimberly Marie McCullough, PA-C

• Pharmacist in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; 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.