Individual provider Active NPI

Balaji Duddukuru

  • Pharmacist
  • East Brunswick, NJ
National Provider Identifier
1154621779
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
055298 Issued in NY
Practice address
6 Plum Tree CT
East Brunswick, NJ 08816-5241
Phone
(917) 754-9467
NPI assigned
Oct 29, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP444523 PA
Pharmacist 183500000X 28RI03355800 NJ
Pharmacist 183500000X 055298 NY Primary

Addresses

Primary practice location

6 Plum Tree CT
East Brunswick, NJ 08816-5241

Mailing address

6 Plum Tree CT
East Brunswick, NJ 08816-5241
Phone (917) 754-9467

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

State licenses

LicenseStateTypeSpecialty
28RI03355800NJMDPharmacist
055298NYMDPharmacist
RP444523PAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1154621779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PLUM TREE CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165241",
            "telephone_number": "917-754-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PLUM TREE CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165241",
            "telephone_number": "917-754-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDDUKURU",
        "first_name": "BALAJI",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-29",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP444523",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03355800",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "055298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.