Active NPI
Alison Sheridan
- Pharmacist
- Mattituck, NY
National Provider Identifier
1710219985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 042626-1
- Practice address
- 10095 Main Rd
Mattituck, NY 11952-1658 - Phone
- (631) 929-6040
- NPI assigned
- Feb 12, 2010
- Last updated
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 042626 | NY | |
| Pharmacist | 183500000X | 042626-1 | NY | Primary |
Addresses
Primary practice location
10095 Main Rd
Mattituck, NY 11952-1658
Mailing address
18 Village GRN N
Baiting Hollow, NY 11933-1328
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042626-1 | NY | MD | Pharmacist |
| 042626 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | 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": "1265932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1710219985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 VILLAGE GRN N",
"city": "BAITING HOLLOW",
"state": "NY",
"postal_code": "119331328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10095 MAIN RD",
"city": "MATTITUCK",
"state": "NY",
"postal_code": "119521658",
"telephone_number": "631-929-6040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERIDAN",
"first_name": "ALISON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-12",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042626",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "042626-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattituck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.