Individual provider Active NPI

Sherene Samu, PHARM.D.

  • Pharmacist
  • Stony Brook, NY
National Provider Identifier
1245463173
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
053796 Issued in NY
Practice address
100 Nicolls Road
Stony Brook University Medical Center, Pharmacy Dept
Stony Brook, NY 11794
Phone
(631) 444-7744
NPI assigned
Aug 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 053796 NY Primary

Addresses

Primary practice location

100 Nicolls Road
Stony Brook University Medical Center, Pharmacy Dept
Stony Brook, NY 11794

Mailing address

100 Nicolls Road
Stony Brook University Medical Center, Pharmacy Dept
Stony Brook, NY 11794

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
053796NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1245463173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "STONY BROOK UNIVERSITY MEDICAL CENTER, PHARMACY DEPT",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS ROAD",
            "address_2": "STONY BROOK UNIVERSITY MEDICAL CENTER, PHARMACY DEPT",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "11794",
            "telephone_number": "631-444-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMU",
        "first_name": "SHERENE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-26",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "053796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2009; 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.