LEGENDARY CARE CONSULTING (NPI# 1669917613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669917613 |
| Entity Type | Organization |
| Organization Name | LEGENDARY CARE CONSULTING |
| Practice Address |
19 Amelia St North Caldwell NJ 07006-4155 |
| Practice Telephone | 9735687830 |
| Mailing Telephone | 9735687830 |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |
| Authorized Official Name | ANKUR JETLEY (OWNER) |
| Authorized Official Telephone | 9735687830 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
28RI02901900 | NJ | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | INDIVIDUAL NPI NUMBER | 1043592926 | 01 |
| Street Address |
19 AMELIA ST |
| City | NORTH CALDWELL |
| State | NJ |
| Zip Code | 07006-4155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063984979 | Ethan and The Bean A New Jersey Non Profit Corporation | Assistant Behavior Analyst | 31 Fairfield Avenue, West Caldwell, NJ 07006 | 2018-12-18 |
| 1083104228 | A Plus Rehab LLC | Physical Medicine & Rehabilitation | 9 Bloomfield Ave, North Caldwell, NJ 07006 | 2018-05-14 |
| 1326556564 | Salvatrice Rosalia Polizzotto | Social Worker | 249 Bloomfield Avenue, 2nd Floor, Caldwell, NJ 07006 | 2018-01-22 |
| 1750820452 | Caldwell University | Behavioral Analyst | 120 Bloombfield Avenue, Caldwell, NJ 07006 | 2017-02-15 |
| 1790151116 | Bankim Shah | Internal Medicine | 32 Wakefield Pl, Caldwell, NJ 07006 | 2015-08-19 |
| 1598157638 | Lisa Santeramo | Behavioral Analyst | 309 Westville Avenue, West Caldwell, NJ 07006 | 2015-02-26 |
| 1871832774 | Theodore K Chang | Dentist | 749 Bloomfield Ave Ste D, West Caldwell, NJ 07006 | 2013-02-12 |
| 1801132535 | Booyoung Chung | Pharmacist | 560 Passiac Ave Cvs, West Caldwell, NJ 07006 | 2012-12-28 |
| 1750611802 | Christopher Jones, Dds, P.a. | Dentist | 1129 Bloomfield Avenue, West Caldwell, NJ 07006 | 2010-01-12 |
| 1194976837 | Arthur Edward Halprin | Dentist | 277 Bloomfield Ave., Caldwell, NJ 07006 | 2008-09-30 |
| Find all providers in zip 07006 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958856 | Pavan K Parimi | Pharmacist | 40 Spruce Meadows Dr, Monroe Township, NJ 08831-3103 | 2020-06-30 |
| 1841814837 | Jibi Philip | Pharmacist | 186 Larch Ave, Dumont, NJ 07628-1327 | 2020-06-04 |
| 1154804185 | Christopher Manuel Bregna | Pharmacist | 60 Fairview Dr, East Hanover, NJ 07936-3508 | 2018-09-14 |
| 1104308121 | Mahwish Zafar | Pharmacist | 1726 Route 37 E, Toms River, NJ 08753-8237 | 2018-09-06 |
| 1386126118 | Panagiota Kousoulis | Pharmacist | 41 Spring St, New Providence, NJ 07974-1143 | 2018-08-29 |
| 1619470606 | Dina Minisi | Pharmacist | 57 Harrowgate Dr, Cherry Hill, NJ 08003-1938 | 2018-03-15 |
| 1720509888 | Sandra Sparta | Pharmacist | 66 Claire Dr, Bridgewater, NJ 08807-1854 | 2017-06-29 |
| 1205377272 | Glatz Rx Consultants LLC | Pharmacist | 54 Broken Arrow Road, Medford, NJ 08055 | 2017-03-10 |
| 1255871745 | Charles W Glatz | Pharmacist | 54 Broken Arrow Bend, Medford, NJ 08055 | 2017-03-02 |
| 1447624184 | Marius Nzo Yonkeu | Pharmacist | 19 Bruen Ave Apt C1, Irvington, NJ 07111 | 2015-11-18 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CALDWELL |
| Zip Code | 07006 |
Please comment or provide details below to improve the information on LEGENDARY CARE CONSULTING.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.