Ange Florent Sibailly, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

27285 Issued in MA

Practice address

256 Lincoln St
Worcester, MA 01605-2105

Phone

(508) 791-2579

Fax

(508) 363-4763

NPI assigned

Oct 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1619692928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BOWKER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016042147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052105",
            "telephone_number": "508-791-2579",
            "fax_number": "508-363-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBAILLY",
        "first_name": "ANGE",
        "middle_name": "FLORENT",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "27285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110087468N",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pointag",
            "affiliation": "N",
            "address_1": "256 Lincoln St",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016052105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Andrew Shustak, D.M.D.
• Stanley A Shustak Jr., DDS
• Judith A Shute, LICSW
• Patricia Elise Siano, NP
• Elizabeth Siaw
• Felicite Sibailly
• Kenneth Sicard, M.D., PH.D.
• Alfida E Siceron-Reyna
• Christine Sicuso
• Joseph N. Sidari, MD

• Pharmacist in Worcester, MA
• Providers in Worcester, MA by specialty
• Pharmacist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.