Individual provider Active NPI

Stephanie Sajumon

  • Addiction (Substance Use Disorder) Registered Nurse
  • Brentwood, NY
National Provider Identifier
1467356964
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
916185 Issued in NY
Practice address
400 Crooked Hill Rd BLDG 2
Brentwood, NY 11717-1039
Phone
(631) 521-8400
NPI assigned
Oct 7, 2026
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 916185 NY Primary

Addresses

Primary practice location

400 Crooked Hill Rd BLDG 2
Brentwood, NY 11717-1039

Mailing address

11711 Myrtle Ave
Richmond Hill, NY 11418-1751
Phone (718) 847-9233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1467356964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 MYRTLE AVE",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114181751",
            "telephone_number": "718-847-9233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CROOKED HILL RD BLDG 2",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117171039",
            "telephone_number": "631-521-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJUMON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-07",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "916185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.