Legendary Care Consulting

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

28RI02901900 Issued in NJ

Legal business name

LEGENDARY CARE CONSULTING

Practice address

19 Amelia St
North Caldwell, NJ 07006-4155

Phone

(973) 568-7830

NPI assigned

Dec 30, 2016

Organization subpart

No

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

Authorized official

Name

Ankur Jetley, PHARM D

Title

Owner

Phone

(973) 568-7830

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1669917613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 AMELIA ST",
            "city": "NORTH CALDWELL",
            "state": "NJ",
            "postal_code": "070064155",
            "telephone_number": "973-568-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 AMELIA ST",
            "city": "NORTH CALDWELL",
            "state": "NJ",
            "postal_code": "070064155",
            "telephone_number": "973-568-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY CARE CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "JETLEY",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-568-7830",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NJ",
            "license": "28RI02901900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1043592926",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Grace Korenstein, MSPT
• Zoran Koroskoski, PT
• Amy Kruvant, LCSW, BCIA-EEG
• Michael Anthony Lahue, MT-BC
• Corinne Anne Laird, LCSW-R
• Luciana Macaluso
• Myrtle Herrin Manalo, MD
• John Carmen Mascola, A.T.,C.
• Mark Mautone
• Sean C McLaughlin, D.C.

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in North Caldwell, NJ
• Providers in North Caldwell, NJ by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.