Active NPI
Esther Yusupova, RPH
- Pharmacist
- North Baldwin, NY
National Provider Identifier
1083882609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 048366
- Practice address
- 1764 Grand Ave
North Baldwin, NY 11510-2431 - Phone
- (516) 223-2020
- Fax
- (516) 546-4312
- NPI assigned
- Feb 17, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 048366 | NY | Primary |
Addresses
Primary practice location
1764 Grand Ave
North Baldwin, NY 11510-2431
Mailing address
941 Carmans Rd
Massapequa, NY 11758-3504
Phone (516) 797-5477
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048366 | Other | NY | NY STATE LICENSE |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048366 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathmark Stores Inc | Past | Accepting new patients | |
| Pathmark Stores Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacy
- Staten Island, NY
- NPI 1558461590
-
- Pharmacy
- Massapequa, NY
- NPI 1699872465
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1083882609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 CARMANS RD",
"city": "MASSAPEQUA",
"state": "NY",
"postal_code": "117583504",
"telephone_number": "516-797-5477",
"fax_number": "516-797-5480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1764 GRAND AVE",
"city": "NORTH BALDWIN",
"state": "NY",
"postal_code": "115102431",
"telephone_number": "516-223-2020",
"fax_number": "516-546-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUSUPOVA",
"first_name": "ESTHER",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-17",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "048366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY STATE LICENSE",
"identifier": "048366",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Baldwin, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.