Active NPI
Sherin Susan Samuel
- Pharmacist
- North Baldwin, NY
National Provider Identifier
1366091472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 066016
- Practice address
- 1968 Grand Ave
North Baldwin, NY 11510-2813 - Phone
- (516) 379-2182
- NPI assigned
- Sep 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 066016 | NY | Primary |
Addresses
Primary practice location
1968 Grand Ave
North Baldwin, NY 11510-2813
Mailing address
1968 Grand Ave
North Baldwin, NY 11510-2813
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
| License | State | Type | Specialty |
|---|---|---|---|
| 066016 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1366091472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1968 GRAND AVE",
"city": "NORTH BALDWIN",
"state": "NY",
"postal_code": "115102813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1968 GRAND AVE",
"city": "NORTH BALDWIN",
"state": "NY",
"postal_code": "115102813",
"telephone_number": "516-379-2182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUEL",
"first_name": "SHERIN",
"middle_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-11",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "066016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.