Active NPI
Latchman Raghunandan, B.S.
- Pharmacist
- Newark, NJ
National Provider Identifier
1497818165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RI20923
- Practice address
- 125 Avon Ave
Newark, NJ 07108-2531 - Phone
- (973) 824-5010
- Fax
- (973) 824-5920
- NPI assigned
- Dec 17, 2006
- Sex
- Male
- 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 | RI20923 | NJ | Primary |
Addresses
Primary practice location
125 Avon Ave
Newark, NJ 07108-2531
Mailing address
125 Avon Ave
Newark, NJ 07108-2531
Phone (973) 824-5010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7946007 | Medicaid | NJ |
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RI20923 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colonial Health Pharmacy | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Newark, NJ
- NPI 1437184926
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1497818165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 AVON AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071082531",
"telephone_number": "973-824-5010",
"fax_number": "973-824-5920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 AVON AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071082531",
"telephone_number": "973-824-5010",
"fax_number": "973-824-5920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAGHUNANDAN",
"first_name": "LATCHMAN",
"name_prefix": "Mr.",
"credential": "B.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "RI20923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7946007",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.