Individual provider Active NPI

Lucy Sourial, MD

  • Hematology (Internal Medicine) Physician
  • New York, NY
National Provider Identifier
1255306403
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
141804 Issued in NY
Practice address
247 Third Ave
New York, NY 10010
Phone
(212) 529-1709
Fax
(212) 529-5205
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X MA66626 NJ
Internal Medicine Physician 207R00000X 141804 NY
Hematology & Oncology Physician 207RH0003X 141804 NY
Medical Oncology Physician 207RX0202X 141804 NY
Hematology (Internal Medicine) Physician 207RH0000X 141804 NY Primary

Addresses

Primary practice location

247 Third Ave
New York, NY 10010

Mailing address

247 Third Ave
New York, NY 10010
Phone (212) 529-1709

Other identifiers 1

IdentifierTypeStateIssuer
00901175MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000591 NY Practitioner - Internal MedicinePractitioner - Hematology/Oncology 6608057963 Practice locations: New York, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA66626NJMDHematology & Oncology Physician
141804NYMDMedical Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1255306403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 THIRD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-529-1709",
            "fax_number": "212-529-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 THIRD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10010",
            "telephone_number": "212-529-1709",
            "fax_number": "212-529-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOURIAL",
        "first_name": "LUCY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "MA66626",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "141804",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NY",
            "license": "141804",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NY",
            "license": "141804",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NY",
            "license": "141804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00901175",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.