Individual provider Active NPI

Maruthi Kumar Dussa

  • Pharmacist
  • Jersey City, NJ
National Provider Identifier
1396049821
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03389100 Issued in NJ
Practice address
371 Central Ave
Jersey City, NJ 07307-2827
Phone
(201) 656-3900
NPI assigned
Dec 23, 2010
Last updated
Dec 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03389100 NJ Primary

Addresses

Primary practice location

371 Central Ave
Jersey City, NJ 07307-2827

Mailing address

371 Central Ave
Jersey City, NJ 07307-2827
Phone (201) 656-3900

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

LicenseStateTypeSpecialty
28RI03389100NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1396049821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072827",
            "telephone_number": "201-656-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 CENTRAL AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073072827",
            "telephone_number": "201-656-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSA",
        "first_name": "MARUTHI KUMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-12-23",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03389100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.