DR. SAMUEL LUIS REVERON (NPI# 1699116012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699116012 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL LUIS REVERON |
| Credential | PHARMD |
| Practice Address |
140 78th St D5 North Bergen NJ 07047-5868 |
| Practice Telephone | 2158402592 |
| Mailing Telephone | 2158402592 |
| Enumeration Date | 2013-07-14 |
| Last Update Date | 2013-07-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
28RI03384200 | NJ | Pharmacy Service Providers |
| Street Address |
140 78TH ST D5 |
| City | NORTH BERGEN |
| State | NJ |
| Zip Code | 07047-5868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850490 | Maria Purita Yballe | Nurse Practitioner | 8100 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-10-29 |
| 1639799646 | Red Oak Pharmacy Corp | Pharmacy | 9225 John F Kennedy Blvd, Unit F, North Bergen, NJ 07047 | 2020-04-20 |
| 1811520091 | Andres A Varilias | Pharmacist | 7917 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-02-17 |
| 1669016986 | Rebecca Lee | Dentist | 3123 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2019-10-30 |
| 1720648439 | Hannah Joy Guharajan | Speech-Language Pathologist | 5665 John F. Kennedy Blvd, Apt. 508, North Bergen, NJ 07047 | 2019-06-14 |
| 1417417080 | Chandini Sajja | Student in an Organized Health Care Education/Training Program | 7600 River Road, North Bergen, NJ 07047 | 2019-03-20 |
| 1215455522 | Xavier Steven Alzate | Specialist/Technologist | 338 75th Street, 2b, North Bergen, NJ 07047 | 2017-09-07 |
| 1962923151 | Hala Altunji | Dentist | 8407 Jfk Blvd E, North Bergen, NJ 07047 | 2017-06-28 |
| 1871023457 | Diego Nieto | Specialist | 6112 Durham Ave, North Bergen, NJ 07047 | 2017-06-15 |
| 1326578105 | Hudson Hills Senior Living, LLC | Nursing Care | 3505 Bergen Tpke, North Bergen, NJ 07047 | 2017-06-14 |
| Find all providers in zip 07047 | ||||
| Taxonomy Code | 1835P1200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacotherapy |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215568829 | Christabel Cash-abbey | Pharmacist | 113 Willow Oaks Ln, Mullica Hill, NJ 08062-4535 | 2020-02-01 |
| 1922591817 | Pharmville, LLC | Pharmacist | 54 Poplar Drive, Morris Plains, NJ 07950-3231 | 2018-06-14 |
| 1841730975 | Anne Conyers Hom | Pharmacist | 8 Hamilton Lakes Dr, Hamilton, NJ 08619-3437 | 2017-03-08 |
| 1861937815 | Karen T Scoullos | Pharmacist | 38 Engle Rd, Paramus, NJ 07652-2130 | 2016-12-29 |
| 1043755275 | Daniel Anane Brown | Pharmacist | 47 Amberly Ct, Franklin Park, NJ 08823-1511 | 2016-12-25 |
| 1740738442 | Cody Ore | Pharmacist | 403 Branch Dr, Mullica Hill, NJ 08062-9473 | 2016-09-12 |
| 1619358728 | Estela Blaustein | Pharmacist | 3110 Promenade Blvd, Fair Lawn, NJ 07410-2777 | 2015-06-15 |
| 1821350596 | Susan A King | Pharmacist | 95 New Brunswick Ave # 101, Perth Amboy, NJ 08861-2294 | 2012-06-08 |
| 1992073167 | Jordan S Gonzalez | Pharmacist | 8 Bleecker St, Jersey City, NJ 07307-2702 | 2011-12-02 |
| 1891077301 | Lisa Lomma | Pharmacist | 208 King George Rd, Pennington, NJ 08534-2320 | 2011-09-12 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BERGEN |
| Zip Code | 07047 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.