Individual provider Active NPI

Cristen Alysse Whittaker, PHARMD

  • Pharmacist
  • Pomona, NJ
National Provider Identifier
1992274344
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03870600 Issued in NJ
Practice address
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone
(856) 357-7701
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03870600 NJ Primary

Addresses

Primary practice location

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102

Mailing address

861 Anthony Rd
Atco, NJ 08004-1254
Phone (856) 357-7701

Other practice location 1

65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone (856) 357-7701

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03870600NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1992274344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 ANTHONY RD",
            "city": "ATCO",
            "state": "NJ",
            "postal_code": "080041254",
            "telephone_number": "856-357-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 W JIMMIE LEEDS RD",
            "city": "POMONA",
            "state": "NJ",
            "postal_code": "082409102",
            "telephone_number": "856-357-7701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 W Jimmie Leeds Rd",
            "address_purpose": "LOCATION",
            "city": "Pomona",
            "state": "NJ",
            "postal_code": "082409102",
            "country_code": "US",
            "telephone_number": "856-357-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "CRISTEN",
        "middle_name": "ALYSSE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03870600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.