Individual provider Active NPI

Mohan Vodoor, RPH

  • Pharmacist
  • New York, NY
National Provider Identifier
1326289349
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
29075 Issued in NY
Practice address
2920 8TH Ave
New York, NY 10039-1610
Phone
(212) 491-5500
Fax
(212) 491-5501
NPI assigned
Mar 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29075 NY Primary

Addresses

Primary practice location

2920 8TH Ave
New York, NY 10039-1610

Mailing address

2920 8TH Ave
New York, NY 10039-1610
Phone (732) 682-5858

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
29075NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside SRX Inc Past Accepting new patients
Riverside Pharmacy,Inc. 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": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237507200000",
    "number": "1326289349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 8TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100391610",
            "telephone_number": "732-682-5858",
            "fax_number": "212-491-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 8TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100391610",
            "telephone_number": "212-491-5500",
            "fax_number": "212-491-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODOOR",
        "first_name": "MOHAN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "29075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.