Individual provider Active NPI

Raj Pande, R.PH

  • Pharmacist
  • North Tonawanda, NY
National Provider Identifier
1275855991
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053280-1 Issued in NY
Practice address
1066 Payne Ave
North Tonawanda, NY 14120-2720
Phone
(716) 694-0323
Fax
(716) 693-1506
NPI assigned
Feb 22, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053280-1 NY Primary
Pharmacist 183500000X 29711 TX

Addresses

Primary practice location

1066 Payne Ave
North Tonawanda, NY 14120-2720

Mailing address

384 Meadow Dr
Apt #4
North Tonawanda, NY 14120-2821
Phone (832) 797-6583

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
29711TXMDDentist
053280-1NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Apr 1, 2022 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1275855991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 MEADOW DR",
            "address_2": "APT #4",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202821",
            "telephone_number": "832-797-6583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 PAYNE AVE",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141202720",
            "telephone_number": "716-694-0323",
            "fax_number": "716-693-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANDE",
        "first_name": "RAJ",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-22",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053280-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "29711",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

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