Active NPI
Srinivasu Maddula, PHARM D.
- Pharmacist
- Edison, NJ
National Provider Identifier
1407178700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI03297400
- Practice address
- 5 Daffodil Dr
Edison, NJ 08837-3089 - Phone
- (732) 841-5784
- NPI assigned
- Feb 28, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03297400 | NJ | Primary |
Addresses
Primary practice location
5 Daffodil Dr
Edison, NJ 08837-3089
Mailing address
5 Daffodil Dr
Edison, NJ 08837-3089
Phone (732) 841-5784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28RI03297400 | Other | NJ | PHARMACIST LICENSE NUMBER |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03297400 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267315200000",
"number": "1407178700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 DAFFODIL DR",
"city": "EDISON",
"state": "NJ",
"postal_code": "088373089",
"telephone_number": "732-841-5784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 DAFFODIL DR",
"city": "EDISON",
"state": "NJ",
"postal_code": "088373089",
"telephone_number": "732-841-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDULA",
"first_name": "SRINIVASU",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-28",
"last_updated": "2010-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03297400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE NUMBER",
"identifier": "28RI03297400",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.