Individual provider Active NPI

Jessica Kachadourian, PHARM D

  • Pharmacist
  • East Orange, NJ
National Provider Identifier
1770893869
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03249200 Issued in NY
Practice address
385 Tremont Ave
East Orange, NJ 07018
Phone
(973) 676-1000
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03249200 NJ
Pharmacist 183500000X 28RI03249200 NY Primary

Addresses

Primary practice location

385 Tremont Ave
East Orange, NJ 07018

Mailing address

385 Tremont Ave
East Orange, NJ 07018-1023
Phone (973) 676-1000

Other practice location 1

83 Bay Street
Montclair, NJ 07042
Phone (401) 439-7274

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
28RI03249200NJMDPharmacist
28RI03249200NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1770893869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "07018",
            "telephone_number": "973-676-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Bay Street",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "07042",
            "country_code": "US",
            "telephone_number": "401-439-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KACHADOURIAN",
        "first_name": "JESSICA",
        "name_prefix": "Ms.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03249200",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "28RI03249200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.