Active NPI
Ejike Chukwukere, PHARM D.
- Pharmacist
- Medford, NY
National Provider Identifier
1952969594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067534
- Practice address
- 1580 Route 112
Medford, NY 11763-3655 - Phone
- (631) 207-9234
- NPI assigned
- May 29, 2019
- Last updated
- Aug 11, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP451907 | PA | |
| Pharmacist | 183500000X | 067534 | NY | Primary |
| Pharmacist | 183500000X | A1-0005123 | DE |
Addresses
Primary practice location
1580 Route 112
Medford, NY 11763-3655
Mailing address
74 Van Cortlandt Park S # 6CC11
Bronx, NY 10463-3003
Phone (917) 545-6200
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 |
|---|---|---|---|
| A1-0005123 | DE | MD | Pharmacist |
| 067534 | NY | MD | Pharmacist |
| RP451907 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691712000000",
"number": "1952969594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 VAN CORTLANDT PARK S # 6CC11",
"city": "BRONX",
"state": "NY",
"postal_code": "104633003",
"telephone_number": "917-545-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 ROUTE 112",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117633655",
"telephone_number": "631-207-9234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUKWUKERE",
"first_name": "EJIKE",
"name_prefix": "Dr.",
"credential": "PHARM D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-29",
"last_updated": "2023-08-11",
"certification_date": "2023-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP451907",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067534",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DE",
"license": "A1-0005123",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.