=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689003915
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASARA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2013
-----------------------------------------------------
Last Update Date | 09/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12613 MERRICK BLVD
-----------------------------------------------------
City | JAMAICA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11434-3419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-528-0505
-----------------------------------------------------
Fax | 718-528-2151
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 126-13 MERRICK BLVD
-----------------------------------------------------
City | JAMAICA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11434
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-528-0505
-----------------------------------------------------
Fax | 718-528-2151
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | RAVI CHITTINEEDI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-528-0505
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 032637
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------