Active NPI
Esar Gangadin, BS
- Pharmacist
- Staten Island, NY
National Provider Identifier
1063705622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 037479
- Practice address
- 45 Victory Blvd
Staten Island, NY 10301 - Phone
- (718) 727-0430
- Fax
- (718) 727-0667
- NPI assigned
- May 16, 2011
- Last updated
- May 16, 2011
- Sex
- Male
- Sole proprietor
- No
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 | 037479 | NY | Primary |
Addresses
Primary practice location
45 Victory Blvd
Staten Island, NY 10301
Mailing address
45 Victory Blvd
Staten Island, NY 10301
Phone (718) 727-0430
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02325464 | Medicaid | NY |
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 037479 | NY | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305504000000",
"number": "1063705622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10301",
"telephone_number": "718-727-0430",
"fax_number": "718-727-0667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 VICTORY BLVD",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10301",
"telephone_number": "718-727-0430",
"fax_number": "718-727-0667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGADIN",
"first_name": "ESAR",
"name_prefix": "Mr.",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-16",
"last_updated": "2011-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "037479",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02325464",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.