Individual provider Active NPI

Dhara D Shah, PHARMD

  • Pediatric Pharmacist
  • Bronx, NY
National Provider Identifier
1073106928
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric PharmacistTaxonomy code 1835P0200X
License
065607 Issued in NY
Practice address
3415 Bainbridge Ave
Bronx, NY 10467-2403
Phone
(718) 484-5103
NPI assigned
Feb 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03877300 NJ
Pediatric Pharmacist 1835P0200X 065607 NY Primary

Addresses

Primary practice location

3415 Bainbridge Ave
Bronx, NY 10467-2403

Mailing address

45 Lincoln Ave
Cliffwood, NJ 07721-1111

Other practice location 1

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-2100

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03877300NJMDPharmacist
065607NYMDPediatric Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1073106928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LINCOLN AVE",
            "city": "CLIFFWOOD",
            "state": "NJ",
            "postal_code": "077211111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-484-5103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHARA",
        "middle_name": "D",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03877300",
            "primary": false
        },
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "NY",
            "license": "065607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.