Organization Active NPI

Siddhipriya Inc

  • Community/Retail Pharmacy
  • Elizabeth, NJ
National Provider Identifier
1760817415
Registry record updated Mar 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28RS00728000 Issued in NJ
Legal business name
SIDDHIPRIYA INC
Doing business as
BERGEN PHARMACY
Practice address
240 Williamson St
Suite # 101
Elizabeth, NJ 07202-3674
Phone
(908) 994-9700
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2014

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

Authorized official

Name
Mr. Devang Rasik Nagrecha, PHARMD
Title
President
Phone
(973) 632-4994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 28RS00728000 NJ Primary

Addresses

Primary practice location

240 Williamson St
Suite # 101
Elizabeth, NJ 07202-3674

Mailing address

23 Canoe Brook Dr
Livingston, NJ 07039-6121
Phone (973) 632-4994

Other names 1

  • BERGEN PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140115000236 NJ DME Supplier - Pharmacy 1658509815 Practice locations: Elizabeth, NJ
O20210125001832 NJ Part B Supplier - Pharmacy 1658509815 Practice locations: Elizabeth, NJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395964800000",
    "number": "1760817415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CANOE BROOK DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070396121",
            "telephone_number": "973-632-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE # 101",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-994-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDDHIPRIYA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2014-03-28",
        "status": "A",
        "authorized_official_last_name": "NAGRECHA",
        "authorized_official_first_name": "DEVANG",
        "authorized_official_middle_name": "RASIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-632-4994",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NJ",
            "license": "28RS00728000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERGEN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.