Kezie Adaku Egbuchulam, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI02485100 Issued in NJ

Practice address

600 Myrtle Ave
Boonton, NJ 07005-1940

Phone

(973) 939-9021

Fax

(973) 939-2368

NPI assigned

Sep 20, 2011

Last updated

Sep 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1063795755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 FARBER HILL RD",
            "city": "BOONTON TOWNSHIP",
            "state": "NJ",
            "postal_code": "070059223",
            "telephone_number": "973-265-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MYRTLE AVE",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051940",
            "telephone_number": "973-939-9021",
            "fax_number": "973-939-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBUCHULAM",
        "first_name": "KEZIE",
        "middle_name": "ADAKU",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02485100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Ryan Donofrio
• Scott Charles Doughty, CADC
• Drug Fair Group, Inc. (Drug Fair of Boonton 54)
• Stacy Lynn Dutka
• Echo Blue Enterprise LLC
• Shelley English
• Irem E Ercan, LCSW
• Erika Pilato Counseling
• Mona Ershadi, MD
• Elizabeth Ann Evans, LPC

• Pharmacist in Boonton, NJ
• Providers in Boonton, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.

Verify at the official NPI Registry.