Individual provider Active NPI

Nancy Sidhom

  • Pharmacist
  • Lynbrook, NY
National Provider Identifier
1053767202
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
060668 Issued in NY
Practice address
367 Peninsula Blvd
Lynbrook, NY 11563-3155
Phone
(516) 469-7025
NPI assigned
May 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 060668 NY Primary

Addresses

Primary practice location

367 Peninsula Blvd
Lynbrook, NY 11563-3155

Mailing address

367 Peninsula Blvd
Lynbrook, NY 11563-3155
Phone (516) 469-7025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060668NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1053767202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 PENINSULA BLVD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633155",
            "telephone_number": "516-469-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 PENINSULA BLVD",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633155",
            "telephone_number": "516-469-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHOM",
        "first_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-06",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "060668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.