Active NPI
Samah Eliwa
- Pharmacist
- Bayonne, NJ
National Provider Identifier
1083352538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04240200
- Practice address
- 974 Broadway
Bayonne, NJ 07002-4054 - Phone
- (201) 471-2400
- NPI assigned
- May 24, 2022
- Last updated
- May 24, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 28RI04240200 | NJ | Primary |
Addresses
Primary practice location
974 Broadway
Bayonne, NJ 07002-4054
Mailing address
285 Saint Marks PL Apt 2J
Staten Island, NY 10301-1842
Phone (929) 571-8141
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 |
|---|---|---|---|
| 28RI04240200 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broadway RX Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1083352538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 SAINT MARKS PL APT 2J",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103011842",
"telephone_number": "929-571-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "974 BROADWAY",
"city": "BAYONNE",
"state": "NJ",
"postal_code": "070024054",
"telephone_number": "201-471-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIWA",
"first_name": "SAMAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04240200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayonne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.