Sergelyne Antoine, PHARMD
Individual provider Active NPI Pharmacist · Union, NJ
NPI 1508460650 · NPPES record last updated Nov 29, 2020
Key facts
- NPI
- 1508460650
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI03700900 (NJ)
- Practice address
- 1011 Morris Ave
Union, NJ 07083-7120 - Phone
- (908) 687-3371
- NPI assigned
- Nov 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03700900 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey CVS Pharmacy LLC | Past |
Accepting new patients | |
| New Jersey CVS Pharmacy LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03700900 | NJ | Yes |
Addresses
Primary practice location
1011 Morris Ave
Union, NJ 07083-7120
Mailing address
267 Cambridge Ave
Jersey City, NJ 07307-1905
Phone (718) 954-5027
Other providers in Union, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.