Active NPI
Samson Yu
- Pharmacist
- Mattapan, MA
National Provider Identifier
1063017044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH237660
- Practice address
- 1575 Blue Hill Ave
Mattapan, MA 02126-2122 - Phone
- (617) 898-1282
- Fax
- (617) 898-1287
- NPI assigned
- Nov 30, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH237660 | MA | Primary |
Addresses
Primary practice location
1575 Blue Hill Ave
Mattapan, MA 02126-2122
Mailing address
27 Lowe St
Quincy, MA 02169-6919
Phone (617) 669-0374
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH237660 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1063017044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 LOWE ST",
"city": "QUINCY",
"state": "MA",
"postal_code": "021696919",
"telephone_number": "617-669-0374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1575 BLUE HILL AVE",
"city": "MATTAPAN",
"state": "MA",
"postal_code": "021262122",
"telephone_number": "617-898-1282",
"fax_number": "617-898-1287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YU",
"first_name": "SAMSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH237660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattapan, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.