Larisa Avramovna Gavrilyuk

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

14061 Ludlow St
Oak Park, MI 48237-1352

Phone

(248) 854-4302

NPI assigned

Feb 28, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Perry Drug Stores Inc and Subsidiaries

  • Community/Retail Pharmacy
  • Huntington Woods, MI
  • NPI 1144339664
  NPD (past)
• Perry Drug Stores Inc and Subsidiaries

  • Community/Retail Pharmacy
  • Commerce Township, MI
  • NPI 1871602391
  NPD (past)

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1124774229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26020 COOLIDGE HWY",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701415",
            "telephone_number": "248-545-8020",
            "fax_number": "248-582-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14061 LUDLOW ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371352",
            "telephone_number": "248-854-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILYUK",
        "first_name": "LARISA",
        "middle_name": "AVRAMOVNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY TECHNICIAN LICENSE",
            "identifier": "5303008597",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carol Gant, O.T.R.
• Michelle Gappy
• Gobind L Garg, MD
• Kamlesh R Garg, MD
• Patrice Dornal Garry, LLBSW
• Rita Geloneck
• Ellen Sherri Gendelman, MS, LPC
• Isabelle George
• Willie Florence George
• Get Well Transportation

• Student in an Organized Health Care Education/Training Program in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.