Active NPI
Narendra B Vutla, PHARMD
- Pharmacist
- Newburgh, NY
National Provider Identifier
1205152683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 054451
- Practice address
- 39 N Plank Rd
Newburgh, NY 12550-2118 - Phone
- (845) 561-3784
- Fax
- (845) 561-2961
- NPI assigned
- Apr 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03187800 | NJ | |
| Pharmacist | 183500000X | 054451 | NY | Primary |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 054451 | NY |
Addresses
Primary practice location
39 N Plank Rd
Newburgh, NY 12550-2118
Mailing address
39 N Plank Rd
Newburgh, NY 12550-2118
Phone (845) 561-3784
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054451 | Other | NY | REGISTERED PHARMACIST |
| 054451-I | Other | NY | IMMUNIZING PHARMACIST |
| 28RI03187800 | Other | NJ | PHARMACIST LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03187800 | NJ | MD | Pharmacist |
| 054451 | NY | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1205152683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 N PLANK RD",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125502118",
"telephone_number": "845-561-3784",
"fax_number": "845-561-2961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 N PLANK RD",
"city": "NEWBURGH",
"state": "NY",
"postal_code": "125502118",
"telephone_number": "845-561-3784",
"fax_number": "845-561-2961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUTLA",
"first_name": "NARENDRA",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-11",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03187800",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "054451",
"primary": true
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "NY",
"license": "054451",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED PHARMACIST",
"identifier": "054451",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IMMUNIZING PHARMACIST",
"identifier": "054451-I",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "28RI03187800",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.