Individual provider Active NPI

Susan Y Lee, RPH

  • Pharmacist
  • Haworth, NJ
National Provider Identifier
1083939029
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02397600 Issued in NJ
Practice address
169 Terrace St
Haworth, NJ 07641-1835
Phone
(201) 384-7171
Fax
(201) 384-4433
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02397600 NJ Primary

Addresses

Primary practice location

169 Terrace St
Haworth, NJ 07641-1835

Mailing address

169 Terrace St
Haworth, NJ 07641-1835
Phone (201) 384-7171

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI02397600NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Terrace Apothecary Inc PastSince Sep 10, 2023 Accepting new patients
Terrace Apothecary Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1083939029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 TERRACE ST",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411835",
            "telephone_number": "201-384-7171",
            "fax_number": "201-384-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 TERRACE ST",
            "city": "HAWORTH",
            "state": "NJ",
            "postal_code": "076411835",
            "telephone_number": "201-384-7171",
            "fax_number": "201-384-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02397600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haworth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.