Individual provider Active NPI

Susan Claire Ludwig

  • Pharmacist
  • Bay Shore, NY
National Provider Identifier
1265614572
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
036432 Issued in NY
Practice address
836 Sunrise Hwy
Bay Shore, NY 11706-5908
Phone
(631) 665-2500
NPI assigned
Nov 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 036432 NY Primary

Addresses

Primary practice location

836 Sunrise Hwy
Bay Shore, NY 11706-5908

Mailing address

45 Hobart St
East Islip, NY 11730-2829
Phone (631) 224-4767

Other identifiers 1

IdentifierTypeStateIssuer
01955531MedicaidNY

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
036432NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1265614572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HOBART ST",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302829",
            "telephone_number": "631-224-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 SUNRISE HWY",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117065908",
            "telephone_number": "631-665-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "SUSAN",
        "middle_name": "CLAIRE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-28",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "036432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01955531",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.