Active NPI
Dalia Sidhom, PHARM D
- Pharmacist
- Milford, CT
National Provider Identifier
1306115472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 3513
- Practice address
- 108 C East Broadway
Milford, CT 06460 - Phone
- (978) 399-8202
- NPI assigned
- Dec 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3513 | NH | Primary |
| Pharmacist | 183500000X | 0011863 | CT | |
| Pharmacist | 183500000X | PH232557 | MA |
Addresses
Primary practice location
108 C East Broadway
Milford, CT 06460
Mailing address
108 E Broadway Apt C
Milford, CT 06460-6143
Phone (978) 399-8202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0011863 | CT | MD | Pharmacist |
| PH232557 | MA | MD | Pharmacist |
| 3513 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324339200000",
"number": "1306115472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 E BROADWAY APT C",
"city": "MILFORD",
"state": "CT",
"postal_code": "064606143",
"telephone_number": "978-399-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 C EAST BROADWAY",
"city": "MILFORD",
"state": "CT",
"postal_code": "06460",
"telephone_number": "978-399-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDHOM",
"first_name": "DALIA",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-20",
"last_updated": "2011-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NH",
"license": "3513",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "0011863",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH232557",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.