DR. CAROL FATTAL (NPI# 1407419062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407419062 |
| Entity Type | Individual |
| Full Name | DR. CAROL FATTAL |
| Credential | PHARMD |
| Practice Address |
4 Shasta Rd Wayne NJ 07470-6114 |
| Practice Telephone | 9738036818 |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 065283 | NY | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | PHARMACIST LICENSE | 065283 | 01 |
| Street Address |
4 SHASTA RD |
| City | WAYNE |
| State | NJ |
| Zip Code | 07470-6114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073086 | Brightview Hamburg, LLC | Alzheimer Center (Dementia Center) | 1139 Hamburg Turnpike, Wayne, NJ 07470 | 2020-11-03 |
| 1912536301 | Stevenson Dominique | Physician Assistant | 1700 Nj-23 # 170, Wayne, NJ 07470 | 2020-04-07 |
| 1710524087 | Engel Burman At Wayne, LLC | Assisted Living Facility | 1440 Hamburg Turnpike, Wayne, NJ 07470 | 2019-12-05 |
| 1508412669 | Jessie Diana Dunitz | Technician | 66 Sandra Lane, Wayne, NJ 07470 | 2019-08-14 |
| 1447737234 | Meza Behavioral Health, Inc. | Psychologist | 40 Edgemont Crescent, Wayne, NJ 07470 | 2018-07-24 |
| 1881188076 | Christine Nolan | Occupational Therapist | 1 Pike Drive, Wayne, NJ 07470 | 2018-06-20 |
| 1033612403 | County of Passaic Department of Finance | Skilled Nursing Facility | 305 Oldham Road, Wayne, NJ 07470 | 2018-03-13 |
| 1144739590 | Broadway Respite and Home Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7 Allen Drive, Wayne, NJ 07470 | 2017-09-28 |
| 1679096697 | Wafaa Saad | Counselor | 1009 Valley Rd, Wayne, NJ 07470 | 2017-07-21 |
| 1659803138 | Allison Nicole Diangelo | Nurse Practitioner | 1578 Rte 23, Wayne, NJ 07470 | 2017-04-03 |
| Find all providers in zip 07470 | ||||
| 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 |
|---|---|---|---|---|
| 1457973786 | Suzanne Jahng | Pharmacist | 109 Old Homestead Rd, Wayne, NJ 07470-4170 | 2020-05-08 |
| 1801416813 | Ramsey A Samy | Pharmacist | 21 Camillo Dr, Wayne, NJ 07470-2924 | 2020-04-20 |
| 1669039657 | Tarick Ali | Pharmacist | 190 French Hill Rd, Wayne, NJ 07470-3932 | 2019-05-24 |
| 1255897930 | Maria Favocci | Pharmacist | 3 Sturbridge Cir, Wayne, NJ 07470-8403 | 2019-02-18 |
| 1366916587 | Rebecca M. Barner | Pharmacist | 402 Douglas St, Wayne, NE 68787-1822 | 2019-01-22 |
| 1205319761 | Matthew Eugene Mcgovern | Pharmacist | 391 Grange Rd, Wayne, PA 19087-2917 | 2018-09-11 |
| 1588156830 | Hythim Saeed Jubara | Pharmacist | 4020 Venoy Rd Ste 900, Wayne, MI 48184-2495 | 2018-06-02 |
| 1295249852 | Peter Andrawis | Pharmacist | 51 Stalter Dr, Wayne, NJ 07470-4156 | 2017-11-18 |
| 1801308028 | Hany A Mikhail | Pharmacist | 23 Timothy Rd, Wayne, NJ 07470-4516 | 2017-10-27 |
| 1639694474 | Conrad D Stumpf | Pharmacist | 1460 Route 23, Wayne, NJ 07470-7503 | 2017-08-12 |
| Find all providers in WAYNE | ||||
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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.