Individual provider Active NPI

Miriam Nathan-Lifshitz

  • Pharmacist
  • Corona, NY
National Provider Identifier
1194047639
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
046153-1 Issued in NY
Practice address
3504C Junction Blvd
Corona, NY 11368-1743
Phone
(718) 424-4538
Fax
(718) 424-4537
NPI assigned
Feb 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 046153-1 NY Primary
Pharmacist 183500000X 0461531 NY

Addresses

Primary practice location

3504C Junction Blvd
Corona, NY 11368-1743

Mailing address

160 Hollywood Xing
Lawrence, NY 11559-2710
Phone (516) 371-5690

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

LicenseStateTypeSpecialty
046153-1NYMDPharmacist
0461531NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Raphael Pharmacy Inc CurrentSince Nov 19, 2023 Accepting new patients
San Isidro Ec Corp PastSince Oct 6, 2019 Accepting new patients

Locations

3504 Junction Blvd
#C
Corona, NY 11368
Phone (718) 424-4538

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.

NPI Registry JSON

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1194047639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 HOLLYWOOD XING",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115592710",
            "telephone_number": "516-371-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504C JUNCTION BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681743",
            "telephone_number": "718-424-4538",
            "fax_number": "718-424-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN-LIFSHITZ",
        "first_name": "MIRIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "046153-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "0461531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.