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Deactivated NPI 1376439950 Deactivated / Inactive NPI

Polla Raid

Pharmacy Technician • Newark, NJ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Polla Raid has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 17, 2025
NPI Deactivation Date January 25, 2026
Total Practice Duration ~1 Years of Practice (2025 – 2026)

Professional Overview & Biography Verified Profile Summary

Polla Raid was a registered Pharmacy Technician practicing in Newark, NJ. Throughout an active medical career spanning 1 years, Polla Raid provided care at the practice location at 75 1ST ST until profile deactivation on 2026-01-25.

Practice Location & Contact Primary Location

Practice Address

75 1st St

Newark, NJ 071073101

Telephone 9739006990
Fax 9739006992
Associated Practice Facility / Clinic
🏢 Ipsn Pharmacy Llc Facility NPI 1194308080

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacy Technician in Newark, NJ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
5 Specialists

Practicing in Newark, NJ (172 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacy Technician Primary Specialty

NUCC Taxonomy Code: 183700000X

State License NJ 28RW04482800

A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Sripriya Nandi

Pharmacist

NPI 1033885868
Kerolous Ferig

Pharmacy Technician

NPI 1669209862

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
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NPI Profile Deactivated January 25, 2026

Record deactivated on January 25, 2026

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NPI Profile Deactivated January 24, 2026

Record deactivated on January 24, 2026

NPI Profile Active June 17, 2025

NPI status registered as active in NPPES database

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Updated Practice Location June 17, 2025

Registered at 75 1ST ST, NEWARK, NJ 071073101 (Tel: 9739006990)

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Updated Business Mailing Address June 17, 2025

Registered at 75 1ST ST, NEWARK, NJ 071073101 (Tel: 9739006990)

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Provider Name / Credentials Updated June 17, 2025

Recorded as POLLA RAID

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2025

Pharmacy Technician (License #28RW04482800 in NJ)

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Initial NPI Registration & Enumeration June 17, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
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NPI Administrative Meta

NPI Number: 1376439950
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 17, 2025
Last Update: June 17, 2025
Deactivation Date: January 25, 2026

Mailing Address

75 1st St

Newark, NJ 071073101

Phone: 9739006990

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.