NPIMap

Organization Active NPI

Rutgers Pharmacy Newark

  • Student Health Clinic/Center
  • Newark, NJ
National Provider Identifier
1124167580
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
License
28RS00306800 Issued in NJ
Legal business name
RUTGERS PHARMACY NEWARK
Practice address
249 University Ave
Newark, NJ 07102-1808
Phone
(973) 353-5201
Fax
(973) 353-1390
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jose Devassy Pullockaran, PH.D., R.PH.
Title
Chief Pharmacist
Phone
(973) 353-5201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X 28RS00306800 NJ Primary

Addresses

Primary practice location

249 University Ave
Newark, NJ 07102-1808

Mailing address

249 University Ave
Newark, NJ 07102-1808
Phone (973) 353-5201

National Provider Directory

National Provider Directory
Tax ID family
Rutgers the State Univ17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

249 University Ave
Newark, NJ 07102
Phone (973) 353-5201

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124167580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 UNIVERSITY AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021808",
            "telephone_number": "973-353-5201",
            "fax_number": "973-353-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 UNIVERSITY AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021808",
            "telephone_number": "973-353-5201",
            "fax_number": "973-353-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS PHARMACY NEWARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PULLOCKARAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "DEVASSY",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "973-353-5201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., R.PH."
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NJ",
            "license": "28RS00306800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.