Individual provider Active NPI

Dider Hossain Bhuiyan

  • Pharmacist
  • Suffern, NY
National Provider Identifier
1811357742
Registry record updated May 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
050402-1 Issued in NY
Practice address
250 Route 59
Suffern, NY 10901-5315
Phone
(845) 368-4682
Fax
(845) 368-4694
NPI assigned
Mar 4, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 050402-1 NY Primary
Pharmacist 183500000X PS 34782 FL

Addresses

Primary practice location

250 Route 59
Suffern, NY 10901-5315

Mailing address

16832 Gothic Dr
3Rd Floord
Jamaica, NY 11432-2044
Phone (239) 634-5057

Other identifiers 2

IdentifierTypeStateIssuer
050402-1OtherNYPHARMACIST STATE LICENSE NUMBER
PS0034782OtherFLPHARMACIST STATE LICENSE NUMBER

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

LicenseStateTypeSpecialty
050402-1NYMDGeneral Practice Dentistry
PS 34782FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463184000000",
    "number": "1811357742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16832 GOTHIC DR",
            "address_2": "3RD FLOORD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322044",
            "telephone_number": "239-634-5057",
            "fax_number": "239-267-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ROUTE 59",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015315",
            "telephone_number": "845-368-4682",
            "fax_number": "845-368-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHUIYAN",
        "first_name": "DIDER",
        "middle_name": "HOSSAIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "050402-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS 34782",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST STATE LICENSE NUMBER",
            "identifier": "050402-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST STATE LICENSE NUMBER",
            "identifier": "PS0034782",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffern, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2016; 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.