Individual provider Active NPI

Srinivasa Reddy Yannam, MS PHARMACY

  • Pharmacist
  • Bronx, NY
National Provider Identifier
1699101212
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0011922 Issued in CT
Practice address
2262 Webster Ave
Bronx, NY 10457-1302
Phone
(718) 733-4150
NPI assigned
Sep 16, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 057640-1 NY
Pharmacist 183500000X PCT.0011922 CT Primary

Addresses

Primary practice location

2262 Webster Ave
Bronx, NY 10457-1302

Mailing address

963 Main St
Apt 1a
Hackensack, NJ 07601-5145
Phone (347) 443-7875

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
Master of Science

State licenses

LicenseStateTypeSpecialty
PCT.0011922CTMDPharmacist
057640-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1699101212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "963 MAIN ST",
            "address_2": "APT 1A",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076015145",
            "telephone_number": "347-443-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 WEBSTER AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104571302",
            "telephone_number": "718-733-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANNAM",
        "first_name": "SRINIVASA",
        "middle_name": "REDDY",
        "credential": "MS PHARMACY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "057640-1",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0011922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.