1407166861 NPI number — VIDYA RANGARAJ HEBBAR PH.D., R.PH.

NPI Number: 1407166861
Health Care Provider/Practitioner: VIDYA RANGARAJ HEBBAR PH.D., R.PH.

NPI Number : 1407166861 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407166861",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HEBBAR",
    "FirstName": "VIDYA",
    "MiddleName": "RANGARAJ",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D., R.PH.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6436 SWIMMER ROW WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21044-4962",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "585-217-9442",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "985 RIDGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WEBSTER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14580-2905",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-872-1380",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/19/2010",
    "LastUpdateDate": "12/08/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "24599",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "183500000X",
          "TaxonomyName": "Pharmacist",
          "LicenseNumber": "054626-1",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}