Active NPI
Meenakshi Vadrevu
- Pharmacist
- New York, NY
National Provider Identifier
1619394459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 063106
- Practice address
- 67 W 137TH St
New York, NY 10037-1953 - Phone
- (212) 926-7500
- Fax
- (212) 926-5900
- NPI assigned
- Mar 18, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 28RI03393400 | NJ | |
| Pharmacist | 183500000X | 063106 | NY | Primary |
Addresses
Primary practice location
67 W 137TH St
New York, NY 10037-1953
Mailing address
35 Woodfern St
Edison, NJ 08820-1441
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 |
|---|---|---|---|
| 063106 | NY | MD | Pharmacist |
| 28RI03393400 | NJ | MD | Pharmacotherapy Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Drugstore Inc | 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
- Elizabeth, NJ
- NPI 1003135195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576022400000",
"number": "1619394459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 WOODFERN ST",
"city": "EDISON",
"state": "NJ",
"postal_code": "088201441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 W 137TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100371953",
"telephone_number": "212-926-7500",
"fax_number": "212-926-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VADREVU",
"first_name": "MEENAKSHI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-18",
"last_updated": "2019-12-11",
"certification_date": "2019-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "NJ",
"license": "28RI03393400",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "063106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.