Individual provider Active NPI

Mukul H Kinariwalla, R.PH

  • Pharmacist
  • Selden, NY
National Provider Identifier
1275693558
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
037077-1 Issued in NY
Practice address
239 Boyle Rd
Selden, NY 11784-1955
Phone
(631) 698-5444
NPI assigned
Dec 9, 2006
Last updated
Jan 5, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 037077-1 NY Primary

Addresses

Primary practice location

239 Boyle Rd
Selden, NY 11784-1955

Mailing address

48 Kemi LN
Sayville, NY 11782-1150
Phone (631) 563-1557

Other identifiers 1

IdentifierTypeStateIssuer
01076168MedicaidNY

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
037077-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Varsha Pharmacy Inc Current Accepting new patients

Locations

239 Boyle Rd
Selden, NY 11784
Phone (516) 736-1311

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1275693558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 KEMI LN",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117821150",
            "telephone_number": "631-563-1557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 BOYLE RD",
            "city": "SELDEN",
            "state": "NY",
            "postal_code": "117841955",
            "telephone_number": "631-698-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINARIWALLA",
        "first_name": "MUKUL",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "037077-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01076168",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selden, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.