Samantha Nisanov, PHARM D

Primary specialty

PharmacistTaxonomy code 183500000X

License

065861 Issued in NY

Practice address

4301 14TH Ave
Brooklyn, NY 11219-1429

Phone

(718) 438-1421

NPI assigned

Dec 2, 2019

Sex

Female

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Life Infusion Pharmacy Corp

  • Community/Retail Pharmacy
  • Brooklyn, NY
  • NPI 1689171852
  NPD (past)
• Life Pharmacy Inc

  • Pharmacist
  • Brooklyn, NY
  • NPI 1275673923
  NPD (past)

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1992342646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112191429",
            "telephone_number": "718-438-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISANOV",
        "first_name": "SAMANTHA",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivana Nirmala
• Aravindh Nirmalan
• Srihar Nirmalan
• Nirmolar Dental PC
• Maksim Nisanov
• Yael Nisanov
• Albina Nisanova, FNP
• Polina Nisanova
• Khamiya Nisbett, CCC-SLP
• Noelle Nisco

• Pharmacist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pharmacist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.