Active NPI
Tara Elengickal
- Infectious Diseases Pharmacist
- Syosset, NY
National Provider Identifier
1053194894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Diseases Pharmacist
- License
- 070246
- Practice address
- 221 Jericho Tpke
Syosset, NY 11791-4515 - Phone
- (516) 673-6620
- NPI assigned
- Aug 15, 2023
- Last updated
- Aug 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP457221 | PA | |
| Infectious Diseases Pharmacist | 1835I0206X | 070246 | NY | Primary |
Addresses
Primary practice location
221 Jericho Tpke
Syosset, NY 11791-4515
Mailing address
414 Lakeview Rd
Bellmore, NY 11710-4211
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 |
|---|---|---|---|
| RP457221 | PA | MD | Pharmacist |
| 070246 | NY | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692057600000",
"number": "1053194894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 LAKEVIEW RD",
"city": "BELLMORE",
"state": "NY",
"postal_code": "117104211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 JERICHO TPKE",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914515",
"telephone_number": "516-673-6620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELENGICKAL",
"first_name": "TARA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-15",
"last_updated": "2023-08-15",
"certification_date": "2023-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP457221",
"primary": false
},
{
"code": "1835I0206X",
"taxonomy_group": "",
"desc": "Pharmacist, Infectious Diseases",
"state": "NY",
"license": "070246",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.