Organization
SIDDHIVINAYAK INC
Active
Other names
BERGEN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RASIK M NAGRECHA RPH (PRESIDENT)
(973) 972-1960
Entity
Organization
Contact information
Practice address
90 BERGEN ST, SUITE 1600, NEWARK, NJ 07103-2425
(973) 972-1960
(973) 972-8158
Mailing address
23 CANOE BROOK DR, LIVINGSTON, NJ 07039-6121
(973) 972-1960
(973) 972-8158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28R00581900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3142053
NCPDP
NJ
05
—
8172501
—
NJ
05
—
8172510
—
NJ
Enumeration date
09/25/2006
Last updated
07/25/2008
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