Active NPI
Samantha Young, PHARMD
- Pharmacist
- Port Jervis, NY
National Provider Identifier
1598073728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 055006
- Practice address
- 76 Pike St
Port Jervis, NY 12771-1827 - Phone
- (845) 856-8342
- Fax
- (845) 856-3501
- NPI assigned
- Sep 22, 2010
- 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 | 055006 | NY | Primary |
Addresses
Primary practice location
76 Pike St
Port Jervis, NY 12771-1827
Mailing address
76 Pike St
Port Jervis, NY 12771-1827
Phone (845) 856-8342
Other practice location 1
315 W 23rd St
New York, NY 10011-2247
Phone (646) 486-7430
Other practice location 2
315 W 23rd St
New York, NY 10011-2247
Phone (646) 486-7430
Other practice location 3
96 Dolson Ave
Middletown, NY 10940-6502
Phone (845) 343-1447
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 |
|---|---|---|---|
| 055006 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duane Reade | Past | Accepting new patients | |
| Duane Reade | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1598073728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "76 PIKE ST",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127711827",
"telephone_number": "845-856-8342",
"fax_number": "845-856-3501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 PIKE ST",
"city": "PORT JERVIS",
"state": "NY",
"postal_code": "127711827",
"telephone_number": "845-856-8342",
"fax_number": "845-856-3501"
}
],
"practiceLocations": [
{
"address_1": "315 W 23rd St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100112247",
"country_code": "US",
"telephone_number": "646-486-7430",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "315 W 23rd St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100112247",
"country_code": "US",
"telephone_number": "646-486-7430",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "96 Dolson Ave",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "NY",
"postal_code": "109406502",
"country_code": "US",
"telephone_number": "845-343-1447",
"fax_number": "845-342-6613",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YOUNG",
"first_name": "SAMANTHA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-22",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "055006",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jervis, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.