Active NPI
Rakeshkumar Shantilal Shah, PHARMACIST
- Pharmacist
- Old Bridge, NJ
National Provider Identifier
1366677387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02656100
- Practice address
- 62 Nathan Dr
Old Bridge, NJ 08857-2790 - Phone
- (732) 588-5032
- NPI assigned
- May 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 045009 | NY | |
| Pharmacist | 183500000X | 28RI02656100 | NJ | Primary |
Addresses
Primary practice location
62 Nathan Dr
Old Bridge, NJ 08857-2790
Mailing address
62 Nathan Dr
Old Bridge, NJ 08857-2790
Phone (732) 588-5032
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 |
|---|---|---|---|
| 28RI02656100 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1366677387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 NATHAN DR",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572790",
"telephone_number": "732-588-5032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 NATHAN DR",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572790",
"telephone_number": "732-588-5032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "RAKESHKUMAR",
"middle_name": "SHANTILAL",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-19",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045009",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02656100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Bridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.