IndividualActive
Samuel Reveron, PHARMD
NPI 1699116012 · Pharmacotherapy Pharmacist · North Bergen, NJ
Provider details
- NPI number
- 1699116012
- Entity type
- Individual
- Primary specialty
- Pharmacotherapy PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 28RI03384200 (NJ)
Mailing address
140 78th St
North Bergen, NJ 07047-5868
Registry dates
- Enumerated
- 2013-07-14
- Last updated
- 2013-07-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.