Shyam Sunder Mudigonda

Primary specialty

PharmacistTaxonomy code 183500000X

License

28RI03189800 Issued in NJ

Practice address

800 Broad St
Newark, NJ 07102-2760

Phone

(973) 596-1800

NPI assigned

Oct 28, 2014

Last updated

Oct 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1306241757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022760",
            "telephone_number": "973-596-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022760",
            "telephone_number": "973-596-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDIGONDA",
        "first_name": "SHYAM SUNDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03189800",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A1-0004392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mt. Carmel Guild - Pact
• Mt. Carmel Guild Engle Center
• Derya Mucahit, DO
• Rohan R Muchintala
• Anita Mudan, MD
• Annette B Mueller, M.D.
• Salman Mughal
• Kareemah Fatimah Muhammad
• Tyreema L Muhannad
• Mulberry Ambulatory Surgical Center, LLC

• Pharmacist in Newark, NJ
• Providers in Newark, NJ by specialty
• Pharmacist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.