Individual provider Active NPI

Martha Samir Henen

  • Pharmacist
  • Perth Amboy, NJ
National Provider Identifier
1215601752
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04157700 Issued in NJ
Practice address
432 Hall Ave
Perth Amboy, NJ 08861-2515
Phone
(732) 442-0163
NPI assigned
Aug 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI04157700 NJ Primary

Addresses

Primary practice location

432 Hall Ave
Perth Amboy, NJ 08861-2515

Mailing address

22 Exeter Rd
Jersey City, NJ 07305-1240

Other names 1

  • Martha Samir Bashir Henen Former name

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
28RI04157700NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Maria Pharmacy, Inc. PastSince Aug 15, 2021 Accepting new patients
Truth Pharmacy Inc. PastSince Aug 15, 2021 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": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1215601752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EXETER RD",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 HALL AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612515",
            "telephone_number": "732-442-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENEN",
        "first_name": "MARTHA",
        "middle_name": "SAMIR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04157700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "BASHIR HENEN",
            "middle_name": "SAMIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2021; 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.