Active NPI
Patrycja Mika
- Pharmacist
- Jackson, NJ
National Provider Identifier
1982117156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04234500
- Practice address
- 430 Harmony Rd
Jackson, NJ 08527-4417 - Phone
- (732) 928-6246
- NPI assigned
- Nov 9, 2017
- Last updated
- Jan 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0014099 | CT | |
| Pharmacist | 183500000X | 28RI04234500 | NJ | Primary |
Addresses
Primary practice location
430 Harmony Rd
Jackson, NJ 08527-4417
Mailing address
99 Ridge Ave
Staten Island, NY 10304-1420
Phone (347) 751-2504
Other practice location 1
1606 Barnum Ave
Stratford, CT 06614-5301
Phone (203) 377-2851
Other practice location 2
1000 Park Ave
Bridgeport, CT 06604-3406
Phone (203) 696-0127
Other practice location 3
275 Monroe Tpke
Monroe, CT 06468-2246
Phone (203) 268-1216
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0014099 | CT | MD | Pharmacist |
| 28RI04234500 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 5
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": "1510185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674172800000",
"number": "1982117156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 RIDGE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103041420",
"telephone_number": "347-751-2504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 HARMONY RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085274417",
"telephone_number": "732-928-6246"
}
],
"practiceLocations": [
{
"address_1": "1606 Barnum Ave",
"address_purpose": "LOCATION",
"city": "Stratford",
"state": "CT",
"postal_code": "066145301",
"country_code": "US",
"telephone_number": "203-377-2851",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 Park Ave",
"address_purpose": "LOCATION",
"city": "Bridgeport",
"state": "CT",
"postal_code": "066043406",
"country_code": "US",
"telephone_number": "203-696-0127",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "275 Monroe Tpke",
"address_purpose": "LOCATION",
"city": "Monroe",
"state": "CT",
"postal_code": "064682246",
"country_code": "US",
"telephone_number": "203-268-1216",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MIKA",
"first_name": "PATRYCJA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-09",
"last_updated": "2023-01-20",
"certification_date": "2023-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "0014099",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04234500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.