Matthew Pallickal Santhosh

Primary specialty

PharmacistTaxonomy code 183500000X

License

RP458894 Issued in PA

Practice address

1111 E End Blvd
Wilkes Barre, PA 18711-0030

Phone

(570) 824-3521

NPI assigned

Oct 9, 2024

Last updated

Oct 9, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1679392377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 COLLINS AVE",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465649",
            "telephone_number": "267-663-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTHOSH",
        "first_name": "MATTHEW",
        "middle_name": "PALLICKAL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP458894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sams East Inc (Sams Pharmacy 10-8191)
• Thomas Samuelsen, MD
• Jill Crompton Sandutch, CRNP-C
• Fnu Sanjna
• Robin Lynn Santey, RN
• Zachary Ruben Santi
• Francisco Santos
• Sapphire Emergency Physicians, PC
• Najam Saqib, M.D.
• Brian Saracino, DO

• Pharmacist in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Pharmacist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.