Individual provider Active NPI

Gokul Kalla, RPH

  • Pharmacist
  • Long Island City, NY
National Provider Identifier
1114427796
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
058306 Issued in NY
Practice address
3711 Queens Blvd
Long Island City, NY 11101-1725
Phone
(718) 361-5100
NPI assigned
Feb 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 058306 NY Primary

Addresses

Primary practice location

3711 Queens Blvd
Long Island City, NY 11101-1725

Mailing address

155 Crowell St
Elmont, NY 11003-1702

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
058306NYMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1114427796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CROWELL ST",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-361-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLA",
        "first_name": "GOKUL",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "058306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.