Organization
SIDDHIVINAYAK INC
Active
Parent organization
SIDDHIVINAYAK INC
Other names
Bergen Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIDDHIVINAYAK INC
Authorized official
MR. RASIK M NAGRECHA (PRESIDENT)
(973) 972-1960
Entity
Organization
Contact information
Practice address
90 BERGEN ST STE 1600, NEWARK, NJ 07103-2425
(973) 972-1960
(973) 972-8158
Mailing address
23 CANOE BROOK DR, LIVINGSTON, NJ 07039-6121
(973) 992-1951
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
28RS00581900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8172510
—
NJ
Enumeration date
09/13/2017
Last updated
09/13/2017
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