Active NPI
Maryam Nagib Gergawi, RPH
- Pharmacist
- Bayonne, NJ
National Provider Identifier
1992362255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04001700
- Practice address
- 490 Broadway
Bayonne, NJ 07002 - Phone
- (347) 403-6198
- NPI assigned
- May 22, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI04001700 | NJ | Primary |
Addresses
Primary practice location
490 Broadway
Bayonne, NJ 07002
Mailing address
6127 69TH PL
Middle Village, NY 11379-1126
Phone (347) 403-6198
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI04001700 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1992362255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6127 69TH PL",
"city": "MIDDLE VILLAGE",
"state": "NY",
"postal_code": "113791126",
"telephone_number": "347-403-6198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 BROADWAY",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "07002",
"telephone_number": "347-403-6198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERGAWI",
"first_name": "MARYAM",
"middle_name": "NAGIB",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-22",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04001700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.