Sedgley Plaza Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP482402 Issued in PA

Legal business name

SEDGLEY PLAZA PHARMACY INC

Doing business as

Sedgley Plaza Pharmacy Inc

Practice address

2917 Ridge Ave
Philadelphia, PA 19121-5215

Phone

(215) 978-0104

Fax

(215) 978-0106

NPI assigned

Apr 3, 2014

Organization subpart

No

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

Authorized official

Name

Ronnie Baksh

Title

Owner/RPH

Phone

(215) 978-0104

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Sedgley Plaza Pharmacy Inc Doing business as

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1396163697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2917 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191215215",
            "telephone_number": "215-978-0104",
            "fax_number": "215-978-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2917 RIDGE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191215215",
            "telephone_number": "215-978-0104",
            "fax_number": "215-978-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDGLEY PLAZA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "BAKSH",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_title_or_position": "OWNER/RPH",
        "authorized_official_telephone_number": "215-978-0104"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP482402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029290730001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145040",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sedgley Plaza Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sedgley Plaza Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Secure Labs LLC
• Daisy Seda
• Paul J Sedacca, MD
• Parisa Sedaghat, MD
• Shabnam Sedaghat, DMD
• Kripa Sedhain
• Gillian Bach Sedigh Haghighat, MD
• Jeanianne T Sedlack, MD
• Armando Sedo Jr.
• Sandi Mae Vivienne See Tai, M.D.

• Community/Retail Pharmacy in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.