Individual provider Active NPI

Shadia Samaan, RPH

  • Pharmacist
  • Mountainside, NJ
National Provider Identifier
1336440486
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03065700 Issued in NJ
Practice address
200 Sheffield St
Mountainside, NJ 07092-2314
Phone
(888) 319-1818
Fax
(877) 290-1812
NPI assigned
Nov 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03065700 NJ Primary

Addresses

Primary practice location

200 Sheffield St
Mountainside, NJ 07092-2314

Mailing address

21 Central Ave
Whitehouse Station, NJ 08889-3415
Phone (908) 442-8844

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03065700NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1336440486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CENTRAL AVE",
            "city": "WHITEHOUSE STATION",
            "state": "NJ",
            "postal_code": "088893415",
            "telephone_number": "908-442-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SHEFFIELD ST",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922314",
            "telephone_number": "888-319-1818",
            "fax_number": "877-290-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMAAN",
        "first_name": "SHADIA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03065700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.