Individual provider Active NPI

Istshhad Reda Shata, PHARM. D.

  • Pharmacist
  • South Plainfield, NJ
National Provider Identifier
1205470820
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04067400 Issued in NJ
Practice address
625 Carbray CT
South Plainfield, NJ 07080-2543
Phone
(732) 895-9911
NPI assigned
Nov 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04067400 NJ Primary

Addresses

Primary practice location

625 Carbray CT
South Plainfield, NJ 07080-2543

Mailing address

625 Carbray CT
South Plainfield, NJ 07080-2543
Phone (732) 895-9911

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
28RI04067400NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1205470820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CARBRAY CT",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802543",
            "telephone_number": "732-895-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CARBRAY CT",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070802543",
            "telephone_number": "732-895-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATA",
        "first_name": "ISTSHHAD",
        "middle_name": "REDA",
        "name_prefix": "Dr.",
        "credential": "PHARM. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-06",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04067400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Plainfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.