Active NPI
Sujatha Kotaru
- Pharmacist
- Havre de Grace, MD
National Provider Identifier
1326451261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17824
- Practice address
- 1003 Pulaski Hwy
Havre de Grace, MD 21078-2603 - Phone
- (410) 939-1140
- NPI assigned
- Jun 9, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17824 | MD | Primary |
Addresses
Primary practice location
1003 Pulaski Hwy
Havre de Grace, MD 21078-2603
Mailing address
165 Haut Brion Ave
Newark, DE 19702-4537
Phone (302) 836-3699
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17824 | MD | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402272000000",
"number": "1326451261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 HAUT BRION AVE",
"city": "NEWARK",
"state": "DE",
"postal_code": "197024537",
"telephone_number": "302-836-3699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1003 PULASKI HWY",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "210782603",
"telephone_number": "410-939-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTARU",
"first_name": "SUJATHA",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-09",
"last_updated": "2014-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "17824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Havre de Grace, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.