MUSHMOOM NIAZ (NPI# 1356907604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356907604 |
| Entity Type | Individual |
| Full Name | MUSHMOOM NIAZ |
| Practice Address |
654 Mount Prospect Ave Newark NJ 07104-3110 |
| Mailing Address |
654 Mt Prospect Newark NJ 07104 |
| Practice Telephone | 8622409603 |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2019-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 28RI04011400 | NJ | Pharmacy Service Providers |
| Street Address |
654 MOUNT PROSPECT AVE |
| City | NEWARK |
| State | NJ |
| Zip Code | 07104-3110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609227248 | Essex Pediatrics & Associates PC | Preferred Provider Organization | 654 Mount Prospect Ave, Newark, NJ 07104-3110 | 2016-06-24 |
| 1609350412 | Prospect Pharmacy | Pharmacy | 654 Mount Prospect Ave, Newark, NJ 07104-3110 | 2018-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538790563 | North Ward Medical Arts LLC | Internal Medicine | 485-491 Mt Prospect Ave, Newark, NJ 07104 | 2020-01-29 |
| 1386149011 | Community Options Enterprises, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 504-506 Mount Prospect Ave, Newark, NJ 07104 | 2018-03-26 |
| 1710406293 | Bmrr Corporation | Durable Medical Equipment & Medical Supplies | 664 Mt Prospect Ave, Newark, NJ 07104 | 2017-09-15 |
| 1508390287 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 387 Ridge Street, Newark, NJ 07104 | 2017-04-19 |
| 1104280890 | North Essex Pediatrics Inc | Clinic/Center | 644 Mt Prospect Ave, Suite1, Newak, NJ 07104 | 2016-04-08 |
| 1306257076 | Sonia Martinez | Technician/Technologist | 677 Mount Prospect Avenue, Newark, NJ 07104 | 2014-05-15 |
| 1891022612 | Sofia Berkovich | Internal Medicine | 717-727 Broadway, Newark, NJ 07104 | 2009-11-16 |
| 1538302138 | Bellazmin Natalie Taylor | Physician Assistant | 354 Doremus Avenue, Newark, NJ 07104 | 2009-04-13 |
| 1740483502 | Clear Vision Optical, Inc. | Eyewear Supplier (Equipment, not the service) | 677 Mt Prospect Avenue, Newark, NJ 07104 | 2007-06-08 |
| 1083815146 | Rafael A Hernandez | Pharmacist | 794 Mt. Prospect Ave., Newark, NJ 07104 | 2007-05-29 |
| Find all providers in zip 07104 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881292720 | Oluwaseun Ademulegun | Pharmacist | 1084 Broad Street, Newark, Newark, NJ 07102 | 2020-10-13 |
| 1023621703 | Theresa Ebinger | Pharmacist | 4114 Ogletown Stanton Rd, Newark, DE 19713-4169 | 2020-08-24 |
| 1689217093 | Princess Ohene | Pharmacist | 3c Windsor Cir, Newark, DE 19702-1493 | 2019-10-18 |
| 1407498165 | Gabrielle Landes | Pharmacist | 50 Halsey St Apt 606t, Newark, NJ 07102-3079 | 2019-10-15 |
| 1033771894 | Vivek Shah | Pharmacist | 451 Bloomfield Ave, Newark, NJ 07107-1866 | 2019-07-02 |
| 1205324910 | Donna Marie Walsh | Pharmacist | 4755 Ogletown Stanton Rd Ofc Le15, Newark, DE 19718-2200 | 2018-04-27 |
| 1619465978 | Nermin R. Boles-attia | Pharmacist | 150 Bergen St Rm B134, Newark, NJ 07103-2496 | 2018-04-23 |
| 1043727589 | Kayleigh M Johnson | Pharmacist | 2000 Tamarack Rd Fl 2, Newark, OH 43055-1183 | 2018-01-05 |
| 1831615327 | Maria Fidelis Ilagan Romero | Pharmacist | 72 W Kyla Marie Dr, Newark, DE 19702-5433 | 2017-08-16 |
| 1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.