Samuel Luis Reveron, PHARMD
NPI 1699116012ActiveIndividual· Pharmacist, Pharmacotherapy· North Bergen, NJ
Pharmacist, Pharmacotherapy (PHARMD) in North Bergen, New Jersey, licensed in NJ, with an NPI issued in July 2013.
Overview
| NPI | 1699116012 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHARMD |
| Sole proprietor | Yes |
| NPI issued | Jul 14, 2013 |
| Last updated in NPPES | Jul 14, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacist, Pharmacotherapy Primary | 1835P1200X | 28RI03384200 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|