Active NPI
Samuel Khaimov
- Pharmacist
- Bronx, NY
National Provider Identifier
1740508951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 044768
- Practice address
- 361 E Fordham Rd
Bronx, NY 10458-5053 - Phone
- (212) 792-4040
- Fax
- (212) 792-4042
- NPI assigned
- May 12, 2010
- Sex
- Male
- 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 | 044768 | NY | Primary |
Addresses
Primary practice location
361 E Fordham Rd
Bronx, NY 10458-5053
Mailing address
361 E Fordham Rd
Bronx, NY 10458-5053
Phone (212) 792-4040
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 |
|---|---|---|---|
| 044768 | NY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1740508951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 E FORDHAM RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104585053",
"telephone_number": "212-792-4040",
"fax_number": "212-792-4042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 E FORDHAM RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104585053",
"telephone_number": "212-792-4040",
"fax_number": "212-792-4042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAIMOV",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-12",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "044768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.