SHIVAJI GAJANAN PHADKE - NPI NUMBER 1972871598

Summary

Provider Name: SHIVAJI GAJANAN PHADKE

NPI Number: 1972871598

Clasification: Pharmacist (183500000X)

Address:
40 HOLLY GLEN LANE NORTH
BERKELEY HEIGHTS, NJ
ZIP 07922

Phone Number: (267) 918-4195



Detailed Information

Shivaji Gajanan Phadke is a pharmacist in Berkeley Heights, NJ. The provider is 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. The assigned NPI number for this provider is 1972871598 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

40 HOLLY GLEN LANE NORTH
BERKELEY HEIGHTS, NJ
ZIP 07922
Phone: (267) 918-4195

The enumeration date for this NPI number is 12/9/2011 and was last updated on 7/2/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 183500000X Pharmacist 28RI03281000 NJ No
2 183500000X Pharmacist 057972 NY No
3 183500000X Pharmacist RP441450 PA Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1972871598 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name PHADKE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name SHIVAJI The first name of the provider, if the provider is an individual.
5 Provider Middle Name GAJANAN The middle name of the provider, if the provider is an individual.
6 Provider First Line Business Practice Location Address 40 HOLLY GLEN LANE NORTH The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name BERKELEY HEIGHTS The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 07922 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 2679184195 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 12/9/2011 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 7/2/2013 The date that a record was last updated or changed.
14 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
15 Healthcare Provider Taxonomy Code 1 183500000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
16 Provider License Number 1 28RI03281000 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
17 Provider License Number State Code 1 NJ The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
18 Healthcare Provider Primary Taxonomy Switch 1 N
19 Healthcare Provider Taxonomy Code 2 183500000X
20 Provider License Number 2 057972 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Provider License Number State Code 2 NY The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
22 Healthcare Provider Primary Taxonomy Switch 2 N
23 Healthcare Provider Taxonomy Code 3 183500000X
24 Provider License Number 3 RP441450 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
25 Provider License Number State Code 3 PA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
26 Healthcare Provider Primary Taxonomy Switch 3 Y
27 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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