Active NPI
Samuel Fares Samuel Botros
- Pharmacist
- Clark, NJ
National Provider Identifier
1841176500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI04448100
- Practice address
- 142 Central Ave
Clark, NJ 07066-1121 - Phone
- (732) 815-9320
- NPI assigned
- Aug 15, 2025
- Last updated
- Aug 15, 2025
- 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 | 28RI04448100 | NJ | Primary |
Addresses
Primary practice location
142 Central Ave
Clark, NJ 07066-1121
Mailing address
142 Central Ave
Clark, NJ 07066-1121
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 |
|---|---|---|---|
| 28RI04448100 | NJ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1841176500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "142 CENTRAL AVE",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 CENTRAL AVE",
"city": "CLARK",
"state": "NJ",
"postal_code": "070661121",
"telephone_number": "732-815-9320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOTROS",
"first_name": "SAMUEL",
"middle_name": "FARES SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-15",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI04448100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.