Active NPI
Uchechukwu Egboluche, PHARMD
- Pharmacist
- Watervliet, NY
National Provider Identifier
1851999502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067165
- Practice address
- 601 19TH St
Watervliet, NY 12189-2002 - Phone
- (518) 500-0000
- NPI assigned
- Oct 14, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 067165 | NY | Primary |
Addresses
Primary practice location
601 19TH St
Watervliet, NY 12189-2002
Mailing address
11 Marvin Ave Apt 1C
Troy, NY 12180-6435
Phone (347) 481-0737
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
| License | State | Type | Specialty |
|---|---|---|---|
| 067165 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1851999502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 MARVIN AVE APT 1C",
"city": "TROY",
"state": "NY",
"postal_code": "121806435",
"telephone_number": "347-481-0737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 19TH ST",
"city": "WATERVLIET",
"state": "NY",
"postal_code": "121892002",
"telephone_number": "518-500-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EGBOLUCHE",
"first_name": "UCHECHUKWU",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.