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
1 NPI 1972871598
2 Entity Type Code 1
3 Provider Last Name Legal Name PHADKE
4 Provider First Name SHIVAJI
5 Provider Middle Name GAJANAN
6 Provider First Line Business Practice Location Address 40 HOLLY GLEN LANE NORTH
7 Provider Business Practice Location Address City Name BERKELEY HEIGHTS
8 Provider Business Practice Location Address State Name NJ
9 Provider Business Practice Location Address Postal Code 07922
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 2679184195
12 Provider Enumeration Date 12/9/2011
13 Last Update Date 7/2/2013
14 Provider Gender Code M
15 Healthcare Provider Taxonomy Code 1 183500000X
16 Provider License Number 1 28RI03281000
17 Provider License Number State Code 1 NJ
18 Healthcare Provider Primary Taxonomy Switch 1 N
19 Healthcare Provider Taxonomy Code 2 183500000X
20 Provider License Number 2 057972
21 Provider License Number State Code 2 NY
22 Healthcare Provider Primary Taxonomy Switch 2 N
23 Healthcare Provider Taxonomy Code 3 183500000X
24 Provider License Number 3 RP441450
25 Provider License Number State Code 3 PA
26 Healthcare Provider Primary Taxonomy Switch 3 Y
27 Is Sole Proprietor Y

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.