Active NPI
Sowmya Vishnubhakthula
- Pharmacist
- Edison, NJ
National Provider Identifier
1023830239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04270200
- Practice address
- 4 Brunswick Ave
Edison, NJ 08817-2500 - Phone
- (732) 777-1717
- NPI assigned
- Oct 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI04270200 | NJ | Primary |
Addresses
Primary practice location
4 Brunswick Ave
Edison, NJ 08817-2500
Mailing address
33 Stanton Rd
Mount Holly, NJ 08060-1398
Phone (504) 952-5054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI04270200 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wasim Corporation | Current | Accepting new patients | |
| Wasim Corporation | Past | Accepting new patients |
Locations
4 Brunswick Ave
Edison, NJ 08817
Phone (732) 777-1717
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Long Term Care Pharmacy
- Edison, NJ
- NPI 1265151153
-
- Community/Retail Pharmacy
- Edison, NJ
- NPI 1750439170
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1023830239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 STANTON RD",
"city": "MOUNT HOLLY",
"state": "NJ",
"postal_code": "080601398",
"telephone_number": "504-952-5054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 BRUNSWICK AVE",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172500",
"telephone_number": "732-777-1717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISHNUBHAKTHULA",
"first_name": "SOWMYA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-29",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04270200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.