Individual provider Active NPI

Rodney Burayidi

  • Pharmacist
  • Suffern, NY
National Provider Identifier
1699212209
Registry record updated Jan 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
060081 Issued in NY
Practice address
250 Route 59
Suffern, NY 10901-5315
Phone
(845) 368-4682
NPI assigned
Jan 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17138 WI
Pharmacist 183500000X 060081 NY Primary
Pharmacist 183500000X 28RI03768700 NJ

Addresses

Primary practice location

250 Route 59
Suffern, NY 10901-5315

Mailing address

250 Route 59
Suffern, NY 10901-5315
Phone (845) 368-4682

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

LicenseStateTypeSpecialty
28RI03768700NJMDPharmacist
060081NYMDPharmacist
17138WIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484956800000",
    "number": "1699212209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015315",
            "telephone_number": "845-368-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015315",
            "telephone_number": "845-368-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURAYIDI",
        "first_name": "RODNEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-21",
        "last_updated": "2017-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "17138",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "060081",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03768700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2017; 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.