Raja S Gorantla, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

049428 Issued in NY

Practice address

408 Blooming Grove Tpke
New Windsor, NY 12553-7841

Phone

(845) 561-5555

Fax

(845) 561-7571

NPI assigned

Jan 2, 2009

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231459200000",
    "number": "1023254646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125537841",
            "telephone_number": "845-561-5555",
            "fax_number": "845-561-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 BLOOMING GROVE TPKE",
            "city": "NEW WINDSOR",
            "state": "NY",
            "postal_code": "125537841",
            "telephone_number": "845-561-5555",
            "fax_number": "845-561-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORANTLA",
        "first_name": "RAJA",
        "middle_name": "S",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "049428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY BOARD OF PHARMACY",
            "identifier": "026389",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02498704",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "3376440",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NPI",
            "identifier": "1720185663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Francis Glynn Jr., RN
• Natalie Gmora-Nyman, MA, LCAT, RDT
• Donna Marie Goff, LMSW
• Magdalena Gonet-Reiss, D.D.S.
• Wanda Gonzalez
• Eda Chiong Gordoncillo, MRS.
• Adriel Gratta
• Andre Green
• Greenburgh - North Castle Ufsd/Kaplan Career Academy
• Greenburgh North Castle

• Pharmacist in New Windsor, NY
• Providers in New Windsor, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.