Individual provider Active NPI

Merna Maged Mouris Salama

  • Pharmacist
  • Staten Island, NY
National Provider Identifier
1174079859
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03802400 Issued in NJ
Practice address
30 Ebbitts St Apt 4B
Staten Island, NY 10306-4829
Phone
(347) 272-3452
NPI assigned
Aug 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03802400 NJ Primary

Addresses

Primary practice location

30 Ebbitts St Apt 4B
Staten Island, NY 10306-4829

Mailing address

30 Ebbitts St Apt 4B
Staten Island, NY 10306-4829
Phone (347) 272-3452

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
28RI03802400NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1174079859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 EBBITTS ST APT 4B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064829",
            "telephone_number": "347-272-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EBBITTS ST APT 4B",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103064829",
            "telephone_number": "347-272-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAMA",
        "first_name": "MERNA",
        "middle_name": "MAGED MOURIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03802400",
            "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 Aug 31, 2016; 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.