Individual provider Active NPI

Kimberly Sansevero

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1144491531
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
048392-1 Issued in NY
Practice address
2660 Hylan Blvd
Staten Island, NY 10306-4355
Phone
(718) 979-1005
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048392-1 NY Primary

Addresses

Primary practice location

2660 Hylan Blvd
Staten Island, NY 10306-4355

Mailing address

12 Brandis Ave
Staten Island, NY 10312-2006
Phone (718) 874-1361

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
048392-1NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1144491531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BRANDIS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103122006",
            "telephone_number": "718-874-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064355",
            "telephone_number": "718-979-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSEVERO",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048392-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.