Individual provider Active NPI

Sophia Liristis, PHARM D

  • Pharmacist
  • Mamaroneck, NY
National Provider Identifier
1114201084
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
056229 Issued in NY
Practice address
430 Mamaroneck Ave
Mamaroneck, NY 10543-2613
Phone
(914) 600-8321
Fax
(914) 600-8322
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 056229 NY Primary

Addresses

Primary practice location

430 Mamaroneck Ave
Mamaroneck, NY 10543-2613

Mailing address

21B Knolls Cres
Bronx, NY 10463-6301

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
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Kasos RX Corp CurrentSince Feb 27, 2022 Accepting new patients

Locations

430 Mamaroneck Ave
Mamaroneck, NY 10543
Phone (914) 600-8321

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1114201084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21B KNOLLS CRES",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104636301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAMARONECK AVE",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105432613",
            "telephone_number": "914-600-8321",
            "fax_number": "914-600-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIRISTIS",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "056229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamaroneck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.