Active NPI
Siddhipriya Inc
- Community/Retail Pharmacy
- Elizabeth, NJ
National Provider Identifier
1760817415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 28RS00728000
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNPI 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.