SM Eshwak Omam, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

066071 Issued in NY

Practice address

464 Main St
Port Jefferson, NY 11777-2814

Phone

(631) 473-2914

NPI assigned

Nov 11, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• CVS Albany LLC

  • Pharmacy
  • Brooklyn, RI
  • NPI 1679459481
  NPD (past)

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1104461490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MALONE ST",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118014627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772814",
            "telephone_number": "631-473-2914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMAM",
        "first_name": "SM",
        "middle_name": "ESHWAK",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "066071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Nicole Odell, FNP-BC
• Nicole Josephine Oganov, MA, CCC-SLP
• Christopher William Oglesby, DDS
• Frank D Oliveto, MD
• Jamie Olschewski, MD
• Marilou Mira Omoyon-Perham, NP
• Muhammed Miran Oncel, MD
• Rebecca M Onuorah
• Patricia Ann Oreilly, P.T.A.
• Francesca Ortenzio

• Pharmacist in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.